Gustavo Luis Gomez Rodriguez, Alejandro Irigoitia Nicolas, Alvaro Muratore, Arnaout Ahlam, Gabriel Clembosky
Head of Teaching and Research at CLIMBA, Clinic of the Hand of Buenos Aires, CLIMBA, Buenos Aires, Argentina.
Deputy Head of Teaching and Research at CLIMBA, Clinic of the Hand of Buenos Aires, CLIMBA, Buenos Aires, Argentina.
J Hand Microsurg. 2025 May 23;17(4):100288. doi: 10.1016/j.jham.2025.100288. eCollection 2025 Jul.
Scapholunate instability is a common wrist injury that significantly affects wrist function and biomechanics. This study compares three internal brace fixation methods for stabilizing the scapholunate interval in cadaveric models with a control group with intact ligaments (Group C): (1) internal brace without interference screw (Group N), (2) internal brace outside the interference screw (Group O), and (3) internal brace within the interference screw (Group I). The study aims to evaluate biomechanical stability, bone integrity, and osteolysis risk. Thirty-two cadaveric wrists were divided into four groups and subjected to biomechanical testing, including static, dynamic, and failure tests. Results showed that Group C exhibited a maximum failure load at 347.6 ± 21.4N; Group I exhibited the highest maximum failure load (319.4 N ± 28.7 N) and no recurrence of Dorsal Intercalated Segment Instability (DISI) during dynamic testing. Group N demonstrated the lowest biomechanical strength (118.5 N ± 15.3 N) and a 75 % DISI recurrence rate. Group O showed intermediate performance, with a maximum failure load of 221.7 N (±24.6 N) and a 37.5 % DISI recurrence rate. Imaging evaluation revealed that Group I had the least bone damage (2.1 % ± 0.9 %), while Group N had the most (24.8 % ± 2.3 %). The study concludes that placing the internal brace within the interference screw (Group I) offers superior biomechanical stability and bone protection, making it a promising technique for scapholunate stabilization. However, further clinical studies are needed to confirm these findings.
舟月骨间不稳定是一种常见的腕部损伤，会显著影响腕部功能和生物力学。本研究在尸体模型中比较了三种用于稳定舟月骨间隙的内支架固定方法，并与韧带完整的对照组（C组）进行对比：（1）不带干涉螺钉的内支架（N组），（2）干涉螺钉外侧的内支架（O组），以及（3）干涉螺钉内的内支架（I组）。该研究旨在评估生物力学稳定性、骨完整性和骨溶解风险。将32个尸体腕部分为四组并进行生物力学测试，包括静态、动态和失效测试。结果显示，C组的最大失效载荷为347.6±21.4N；I组表现出最高的最大失效载荷（319.4N±28.7N），且在动态测试中未出现背侧插入节段不稳定（DISI）复发。N组的生物力学强度最低（118.5N±15.3N），DISI复发率为75%。O组表现中等，最大失效载荷为221.7N（±24.6N），DISI复发率为37.5%。影像学评估显示，I组的骨损伤最少（2.1%±0.9%），而N组最多（24.8%±2.3%）。该研究得出结论，将内支架置于干涉螺钉内（I组）可提供更好的生物力学稳定性和骨保护，使其成为一种有前景的舟月骨稳定技术。然而，需要进一步的临床研究来证实这些发现。
