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Trentadue TP, Lopez C, Breighner RE, Akbari-Shandiz M, An KN, Leng S, Holmes DR, Moran SL, Kakar S, Smith J, Thoreson A, Zhao KD. Assessing carpal kinematics following scapholunate interosseous ligament injury ex vivo using four-dimensional dynamic computed tomography. Clin Biomech (Bristol, Avon) 2023; 107:106007. [PMID: 37295340 PMCID: PMC10619963 DOI: 10.1016/j.clinbiomech.2023.106007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/28/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Scapholunate interosseous ligament injuries are prevalent and often challenging to diagnose radiographically. Four-dimensional CT allows visualization of carpal bones during motion. We present a cadaveric model of sequential ligamentous sectionings ("injuries") to quantify their effects on interosseous proximities at the radioscaphoid joint and scapholunate interval. We hypothesized that injury, wrist position, and their interaction affect carpal arthrokinematics. METHODS Eight cadaveric wrists were moved through flexion-extension and radioulnar deviation after injuries. Dynamic CT images of each motion were acquired in each injury condition using a second-generation dual-source CT scanner. Carpal osteokinematics were used to calculate arthrokinematic interosseous proximity distributions during motion. Median interosseous proximities were normalized and categorized by wrist position. Linear mixed-effects models and marginal means tests were used to compare distributions of median interosseous proximities. FINDINGS The effect of wrist position was significant for both flexion-extension and radioulnar deviation at the radioscaphoid joint; the effect of injury was significant for flexion-extension at the scapholunate interval; and the effect of their interaction was significant for radioulnar deviation at the scapholunate interval. Across wrist positions, radioscaphoid median interosseous proximities were less able to distinguish injury conditions versus scapholunate proximities. Median interosseous proximities at the scapholunate interval are majoritively able to detect differences between less (Geissler I-III) versus more (Geissler IV) severe injuries when the wrist is flexed, extended, and ulnarly-deviated. INTERPRETATION Dynamic CT enhances our understanding of carpal arthrokinematics in a cadaveric model of SLIL injury. Scapholunate median interosseous proximities in flexion, extension, and ulnar deviation best demonstrate ligamentous integrity.
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Affiliation(s)
- Taylor P Trentadue
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America; Mayo Clinic Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States of America; Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States of America.
| | - Cesar Lopez
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
| | - Ryan E Breighner
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States of America.
| | - Mohsen Akbari-Shandiz
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America
| | - Kai-Nan An
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
| | - Shuai Leng
- Department of Radiology, Mayo Clinic, Rochester, MN, United States of America; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America.
| | - David R Holmes
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America; Biomedical Imaging Resource, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, United States of America.
| | - Steven L Moran
- Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN, United States of America.
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN, United States of America; Department of Clinical Anatomy, Mayo Clinic, Rochester, MN, United States of America.
| | - Jay Smith
- Department of Radiology, Mayo Clinic, Rochester, MN, United States of America; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
| | - Andrew Thoreson
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
| | - Kristin D Zhao
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States of America; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America.
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