de Roo Marieke G A, Muurling Marijn, Dobbe Johannes G G, Brinkhorst Michelle E, Streekstra Geert J, Strackee Simon D
1 Plastic, Reconstructive and Hand Surgery, University of Amsterdam, Amsterdam UMC, The Netherlands.
2 Biomedical Engineering and Physics, University of Amsterdam, Amsterdam UMC, The Netherlands.
J Hand Surg Eur Vol. 2019 Jun;44(5):479-487. doi: 10.1177/1753193419830924. Epub 2019 Feb 27.
Additional fixation of the palmar scapholunate interosseous ligament has been advocated to improve the long-term results of dorsal scapholunate interosseous ligament reconstruction. To investigate the validity of this approach, we determined normal scapholunate motion patterns and calculated the location of the scapholunate rotation axis. We hypothesized that the optimal location of the scapholunate interosseous ligament insertion could be determined from the scapholunate rotation axis. Four-dimensional computerized tomography was used to study the wrist motion in 21 healthy participants. During flexion-extension motions, the scaphoid rotates 38° (SD 0.6°) relative to the lunate; the rotation axis intersects the dorsal ridge of the proximal pole of the scaphoid and the dorsal ridge of the lunate. Minimal scapholunate motion is present during radioulnar deviation. Since the scapholunate rotation axis runs through the dorsal proximal pole of the scaphoid, this is probably the optimal location for attaching the scapholunate ligament during reconstructive surgery.
有人主张额外固定掌侧舟月骨间韧带，以改善背侧舟月骨间韧带重建的长期效果。为了研究这种方法的有效性，我们确定了正常的舟月运动模式，并计算了舟月旋转轴的位置。我们假设舟月骨间韧带插入的最佳位置可以根据舟月旋转轴来确定。我们使用四维计算机断层扫描研究了21名健康参与者的腕关节运动。在屈伸运动过程中，舟骨相对于月骨旋转38°（标准差0.6°）；旋转轴与舟骨近端极的背嵴和月骨的背嵴相交。在桡尺偏斜过程中，舟月运动最小。由于舟月旋转轴穿过舟骨的背侧近端极，这可能是重建手术中附着舟月韧带的最佳位置。
