In Vivo Load-Displacement Behavior of the Carpal Scaphoid Ligament Complex: Initial Measurements, Time-Dependence, and Repeatability

Abstract

Hyperextension injuries of the wrist account for a wide variety of wrist pathology, from what may be perceived as a mild “sprain” to the extreme of fracture-dislocation. Ligamentous injuries, which are notoriously difficult to diagnosis with imaging techniques, may progress to overt instability and carpal collapse. Without radiographic carpal malalignment, wrist instability may be assessed by isolating and manually displacing portions of the carpus. This clinical “scaphoid shift test” is an attempt to dorsally subluxate the scaphoid with a manual load applied at its tubercle.⁸ An observation of increased carpal displacement, especially if symptomatic, may indicate ligamentous injury or disruption. However, a clinical observation such as this is subjective.