In Vivo Elongation of the Palmar and Dorsal Scapholunate Interosseous Ligament

Abstract

To investigate the elongation of the palmar and dorsal subregions of the scapholunate interosseous ligament (SLIL) in healthy human subjects throughout a complete range of wrist motion. The 3-dimensional in vivo kinematics of the scaphoid and lunate were determined in both wrists of 13 female and 13 male volunteers from computed tomography volume images. For each wrist the palmar and dorsal insertions of the SLIL were identified on reconstructed surface models of the scaphoid and lunate. The interbone distances between the palmar and dorsal sites were calculated for the neutral wrist position. Elongations were then calculated after applying the 3-dimensional kinematics to the scaphoid and lunate. A multiple linear regression model was used to determine if elongations varied significantly as a function of wrist flexion/extension and radioulnar deviation. From pure wrist extension to pure wrist flexion, the fibers of the SLIL at the palmar insertion site increased significantly, from 29% shortening to 27% elongation, and the dorsal insertion decreased from 26% to 4% shortening with respect to the fiber lengths in the neutral position. From pure radial deviation to pure ulnar deviation, the elongation of the palmar insertion significantly decreased from 9% elongation to 21% shortening. There was no notable change in dorsal elongation with wrist radioulnar deviation. The multiple linear regression model predicted that there would be minimal elongation of the palmar and dorsal fibers at the wrist position along the dart thrower's path from radial extension to ulnar flexion. In vivo elongation of the palmar and dorsal fibers of the SLIL varied with wrist position. The palmar fibers lengthened and the dorsal fibers shortened with wrist flexion and the opposite occurred with wrist extension. Scapholunate interosseous ligament elongation was minimal as the wrist was positioned along the dart thrower's path.