Carpal Ligament Surgery: Before Arthritis by V. Feipel (auth.), Emmanuel Camus, Luc Van Overstraeten

By V. Feipel (auth.), Emmanuel Camus, Luc Van Overstraeten (eds.)

It has by means of now been validated that carpal ligamentary lesions could lead to instability and finally to carpal arthritis. in spite of the fact that, the diversity of anatomopathological classifications and the multiplicity of surgical fix ideas mirror the trouble of greedy this ligamentary pathology.
Clinical research and conventional research ideas needs to effectively deal with the complexity of the wrist, that is principally a result of variety of synchronized bones all for each circulation of the hand. The scientific research of the wrist is inadequate to exactly degree the mobility of every carpal bone, making paraclinical examinations additionally major for scientific analysis. The instruments on hand this day diversity from X-rays to arthroscopy, together with arthroCTscans and shortly MRI. As for fix ideas, their variety must never conceal the truth that a biomechanical and physiological precept is concerned and needs to be pointed out.
This publication provides the findings of knowledgeable team within the box of wrist pathology. It seeks to investigate, comprehend, clarify and make understandable, if no longer noticeable, the reflections that every practitioner may still hire in the course of the analysis and remedy of carpal ligamentary lesions. the focal point is consciously now not on degenerative carpal pathology, which typically enjoys extra visibility. we are hoping that readers will enjoy the indisputable fact that fragmented items of information are collected in one paintings, that they're going to locate during this preliminary synthesis an suggestion to reconsider a tough and infrequently thankless surgical procedure and to extra the surgical advances of the twenty first century.

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4 Scaphotriquetral ligament, 5 Radioscaphocapitate ligament, 15 Dorsal radiocarpal ligament, 16 Dorsal intercarpal ligament, 17 Carpal anterior annular ligament, 18 Radiolunotriquetral ligament Fig. 9 Lifting of the radioscaphocapitate ligament by the scaphoid tubercle during radial inclination. (a) Ulnar inclination. (b) Radial inclination. 5 Radioscaphocapitate ligament The triquetocapitate ligament (Fig. 7-8) is tensed from the radial angle distal from the triquetrum to the ulnar part of the capitate’s body [68].

7 Conclusion Because the scapholunar ligament is exposed to axial constraints of mobility and loads, it represents a weak point of the proximal row. But it is protected by quite a complete system of extrinsic ligaments which contribute to unify the wrist. There are a palmar ligamentous plane, a dorsal ligamentous plane and a distal scaphoidal ligamentous complex. The different tendons around the wrist can also have a cohesion effect of the carpus. A ligamentous injury is less likely to happen if the scapholunar ligament is unaffected.

J Hand Surg Am 14A:852–857 71. Ritt MJPF, Bishop AT, Berger RA, Linscheid RL, Berglund LJ, An KN (1998) Lunotriquetral ligament properties: a comparison of three anatomic subregions. J Hand Surg Am 23A:425–431 72. Salvia P, Klein P, David JH, Rooze M (1994) The envelope of active wrist circumduction: an in vivo electrogoniometric study. In: Schuind F, An KN, Cooney WP, Garcia-Elias M (eds) Advances in the biomechanics of the hand and wrist, vol 256, NATO ASI series. Plenum Press, New York, pp 313–328 73.

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