Clinical significance of measuring the length changes of the scapholunate interosseous ligament during wrist flexion and extension using CT three-dimensional scanning technology
Objective To investigate the feasibility and clinical significance of measuring the length changes of the scapholunate interosseous ligament during wrist flexion and extension using computer tomography(CT)technology.Methods Six healthy volunteers were recruited to undergo CT scans of one wrist joint.Five wrist joint positions per case were scanned,ranging from wrist flexion 60° to dorsal extension 60°,with each additional 30° scan.The Mimics software was used to perform three-dimensional reconstruction of the scaphoid and lunate bones on the scanned images,and then the starting and ending regions of the interosseous ligaments on the three-dimensional images were divided into three sub regions on average,namely the palmar region,proximal region,and dorsal region.Each subregion also simulates three evenly distributed ligament bundles based on the position of the ligament start and end points.The distance between the starting and ending points of each ligament bundle was measured using the measurement tool of Geomagic Studio software,and the length changes of each ligament bundle at different wrist joint flexion and extension positions were compared and analyzed.Results From the neutral position to the 60° flexion position,the length of the scapholunate interosseous ligament in the palmar and proximal subregions significantly increased(P＜0.05).From the neutral position to the dorsal extension 60° position,the intermediate and dorsal tracts in the proximal subregion significantly lengthened(P＜0.05).From the neutral position to the flexion 30° position and dorsal extension 30° position,the distal bundle of the palmar subregion significantly lengthened(P＜0.05).There was no statistically significant difference in the length of the remaining ligament bundles at different wrist joint positions(P＞0.05).Conclusion During the flexion and extension process of the wrist joint,there are significant changes in the length of the palmar and proximal subregions of the scapholunate interosseous ligament,while the dorsal subregions show minimal changes.The best fixation position is the wrist slight extension(0° to 30°)when the volar scapholunate interosseous ligament is injured.The optimal fixation position is the neutral position for injuries to the proximal scapholunate interosseous ligament.It does not require wrist fixation in a special position for injuries to the dorsal scapholunate interosseous ligament.It is recommended to fix the wrist in a neutral or slightly flexion.The neutral position should be appropriate for injuries to the scapholunate interosseous ligamentin all areas.
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