Abstract
The so-called intrinsic ligamentous structures, scapholunate and pyramido-lunate are implied in the instabilities which are said to be dissociative. Just like ‘noninvasive’ imagery (MRI and arthroscanner), arthroscopy is a means to study these ligamentous structures. It has even been reported that the arthroscanner has an excellent ‘sensitiveness’ to detect breaches in the interosseous ligaments [1]. Nevertheless, arthroscopy’s superiority is to be found in the dynamic aspect of this exam, which not only enables to study the mechanical qualities of these ligaments but also to analyse the consequences of a ligamentous lesion resorting to dynamic tests. Only one diagnostic stage is enough to prove a ligamentous injury and, even more important, to demonstrate the consequences of this injury on the dynamics of the carpal bones, asserting or invalidating the existence of an instability or a dissociation. To end up, the same exam enables to accurately analyse the chondral impact of the instability and thus contributes to evaluate how long it has been lasting. The quality of the ligamentous stumps can also be studied to judge whether a fixing by direct suture is possible or not. For all these reasons, arthroscopy remains the gold standard to diagnose dissociative instabilities.
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Dautel, G., Delétang, F. (2013). Application of Wrist Arthroscopy to the Study of the Intrinsic Ligaments. In: Camus, E., Van Overstraeten, L. (eds) Carpal Ligament Surgery. Springer, Paris. https://doi.org/10.1007/978-2-8178-0379-1_8
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DOI: https://doi.org/10.1007/978-2-8178-0379-1_8
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