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In part based on these concerns, some surgeon prefer to maintain the lunate in patients younger than 40 years proximal row carpectomy. [6] [18] A surgery called four-corner arthrodesis is an option. [6] The capitate, lunate, hamate and triquetrum are fused together in this procedure and the scaphoid is excised.
The most frequently performed surgery is the Proximal Row Carpectomy, where the lunate, scaphoid and triquetrum are extracted. This greatly limits the range of motion of the wrist, but pain relief can be achieved for longer than after the other surgeries.
An example of a coalition between the trapezoid and capitate carpal bones. The lunate and triquetral bones are the most common carpal bones to fuse together, resulting in a lunotriquetral coalition in 1% of people. 60% of patients with a lunotriquetral coalition will have it bilaterally. [1]
The scapholunate ligament is an intraarticular ligament binding the scaphoid and lunate bones of the wrist together. It is divided into three areas, dorsal, proximal and palmar, with the dorsal segment being the strongest part. [3] It is the main stabilizer of the scaphoid. In contrast to the scapholunate ligament, the lunotriquetral ligament ...
Ulnar triquetral column: triquetrum and hamate; In this context the pisiform is regarded as a sesamoid bone embedded in the tendon of the flexor carpi ulnaris. [4] The ulnar column leaves a gap between the ulna and the triquetrum, and therefore, only the radial or scaphoid and central or capitate columns articulate with the radius.
The cavity of the midcarpal joint is very extensive and irregular. The major portion of the cavity is located between the distal surfaces of the scaphoid, lunate, and triquetrum and proximal surfaces of the four bones of the distal row. Proximal prolongations of the cavity occur between the scaphoid and lunate and between the lunate and triquetrum.
Preiser disease, or avascular necrosis of the scaphoid, is a rare condition where ischemia and necrosis of the scaphoid bone occurs without previous fracture.It is thought to be caused by repetitive microtrauma or side effects of drugs (e.g., steroids or chemotherapy) in conjunction with existing defective vascular supply to the proximal pole of the scaphoid.
Anatomic illustrations of the wrist depicting the progressive stages of scapholunate advanced collapse. (A) Normal wrist demonstrating an intact scapholunate ligament (white arrowhead), normal scapholunate interval, and preservation of the joint spaces. (S = scaphoid, L = lunate, C = capitate, R = radius, U = ulna).