TY - JOUR
T1 - Scaphoid anatomy and mechanics
T2 - Update and review
AU - Patterson, Rita M.
AU - Moritomo, Hisao
AU - Yamaguchi, Satoshi
AU - Mitsuyasu, Hiromichi
AU - Shah, Munir A.
AU - Buford, William L.
AU - Viegas, Steven F.
PY - 2004/9
Y1 - 2004/9
N2 - This review has been an attempt to collate previous research on scaphoid anatomy, load mechanics, and kinematics into one article so that the reader can assimilate the information in a convenient way. This will hopefully assist in understanding the role of the scaphoid and the various types of injuries to and treatments of scaphoid fractures and ligament injuries. Three new areas of information can be emphasized from this work: 1) the use of plain radiographic analysis to assess scaphoid anatomy and correlate with degenerative changes in the STT joint; 2) the importance of the dorsal ligaments to scaphoid stability; and 3) STT kinematics during radial/ulnar deviation and flexion/extension motion. It is important to understand the different bone and ligament anatomy and the presence of degenerative changes. Of particular importance is the assessment of these anatomic differences from plain radiographs. Plain radiographs can be used to measure TT inclination, which has been shown to correlate with degenerative changes in the STT joint. Research in our laboratory has demonstrated that wrists with a higher TT inclination had a higher incidence of degenerative changes. Knowledge of the anatomy of the dorsal carpal ligaments has also provided a wealth of information on their role in carpal motion. The lateral V construct of the DRC, DIC, and dorsal component of the SLIO ligament delivers indirect dorsal stability, yet allows relative free motion of the scaphoid. This new perspective takes a more global view of how anatomy affects motion and how important these ligaments are in carpal stability. Finally, motion in the STT joint was analyzed during flexion/extension and radial/ulnar deviation of the wrist. Interestingly, the STT joint motion is in the same plane no matter what motion the wrist is going through. This allows us to better model and describe the STT joint while also allowing us to better understand the STT joint's role and how it affects different clinical treatment options.
AB - This review has been an attempt to collate previous research on scaphoid anatomy, load mechanics, and kinematics into one article so that the reader can assimilate the information in a convenient way. This will hopefully assist in understanding the role of the scaphoid and the various types of injuries to and treatments of scaphoid fractures and ligament injuries. Three new areas of information can be emphasized from this work: 1) the use of plain radiographic analysis to assess scaphoid anatomy and correlate with degenerative changes in the STT joint; 2) the importance of the dorsal ligaments to scaphoid stability; and 3) STT kinematics during radial/ulnar deviation and flexion/extension motion. It is important to understand the different bone and ligament anatomy and the presence of degenerative changes. Of particular importance is the assessment of these anatomic differences from plain radiographs. Plain radiographs can be used to measure TT inclination, which has been shown to correlate with degenerative changes in the STT joint. Research in our laboratory has demonstrated that wrists with a higher TT inclination had a higher incidence of degenerative changes. Knowledge of the anatomy of the dorsal carpal ligaments has also provided a wealth of information on their role in carpal motion. The lateral V construct of the DRC, DIC, and dorsal component of the SLIO ligament delivers indirect dorsal stability, yet allows relative free motion of the scaphoid. This new perspective takes a more global view of how anatomy affects motion and how important these ligaments are in carpal stability. Finally, motion in the STT joint was analyzed during flexion/extension and radial/ulnar deviation of the wrist. Interestingly, the STT joint motion is in the same plane no matter what motion the wrist is going through. This allows us to better model and describe the STT joint while also allowing us to better understand the STT joint's role and how it affects different clinical treatment options.
UR - http://www.scopus.com/inward/record.url?scp=4344631609&partnerID=8YFLogxK
U2 - 10.1016/j.ahc.2004.06.002
DO - 10.1016/j.ahc.2004.06.002
M3 - Review article
AN - SCOPUS:4344631609
SN - 1082-3131
VL - 9
SP - 129
EP - 140
JO - Atlas of Hand Clinics
JF - Atlas of Hand Clinics
IS - 2
ER -