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  • Biomechanics of an Articulated Screw in Acute Scapholunate Ligament Disruption

    Author(s)
    Hiro, Matthew E
    Schiffman, Corey J
    Muriuki, Muturi G
    Havey, Robert M
    Voronov, Leonard I
    Bindra, Randy R
    Griffith University Author(s)
    Bindra, Randy
    Year published
    2018
    Metadata
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    Abstract
    Background: An injury to the scapholunate interosseous ligament (SLIL) leads to instability in the scapholunate joint. Temporary fixation is used to protect the ligament during reconstruction or healing of the repair. Rigid screw fixation-by blocking relative physiological motion between the scaphoid and lunate-can lead to screw loosening, pullout, and fracture. Purpose  This study aims to evaluate changes in scaphoid and lunate kinematics following SLIL injury and the effectiveness of an articulating screw at restoring preinjury motion. Materials and Methods  The kinematics of the scaphoid and lunate were measured in 10 ...
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    Background: An injury to the scapholunate interosseous ligament (SLIL) leads to instability in the scapholunate joint. Temporary fixation is used to protect the ligament during reconstruction or healing of the repair. Rigid screw fixation-by blocking relative physiological motion between the scaphoid and lunate-can lead to screw loosening, pullout, and fracture. Purpose  This study aims to evaluate changes in scaphoid and lunate kinematics following SLIL injury and the effectiveness of an articulating screw at restoring preinjury motion. Materials and Methods  The kinematics of the scaphoid and lunate were measured in 10 cadaver wrists through three motions driven by a motion simulator. The specimens were tested intact, immediately following SLIL injury, after subsequent cycling, and after fixation with a screw. Results  Significant changes in scaphoid and lunate motion occurred following SLIL injury. Postinjury cycling increased motion changes in flexion-extension and radial-ulnar deviation. The motion was not significantly different from the intact scapholunate joint after placement of the articulating screw. Conclusion  In agreement with other studies, sectioning of the SLIL led to significant kinematic changes of the scaphoid and lunate in all motions tested. Compared with intact scapholunate joint, no significant difference in kinematics was found after placement of the screw indicating a correction of some of the changes produced by SLIL transection. These findings suggest that the articulating screw may be effective for protecting a SLIL repair while allowing the physiological rotation to occur between the scaphoid and lunate. Clinical Relevance  A less rigid construct, such as the articulating screw, may allow earlier wrist rehabilitation with less screw pullout or failure.
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    Journal Title
    Journal of Wrist Surgery
    Volume
    7
    Issue
    2
    DOI
    https://doi.org/10.1055/s-0037-1608637
    Subject
    Surgery
    Biomechanics
    Orthopaedics
    Science & Technology
    Life Sciences & Biomedicine
    Orthopedics
    scapholunate interosseous ligament injury
    scaphoid and lunate kinematics
    Publication URI
    http://hdl.handle.net/10072/407233
    Collection
    • Journal articles

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