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Traumatic Instability of the Wrist Diagnosis, Classification, and Pathomechanics
Ronald L. Linscheid, MD; James H. Dobyns, MD; John W. Beabout, MD; Richard S. Bryan, MD
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From the Mayo Clinic and Mayo Foundation, Rochester, Minnesota
Appeared in JBJS, Vol. 54-A, No. 8, pp. 1612-32, December 1972

J Bone Joint Surg Am, 2002 Jan 01;84(1):142-142
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The scaphoid is a mechanical link that stabilizes the intercarpal joint during motions of the wrist. Without this stability the proximal carpal row acts as an unsupported intercalated link in a three-link system and zigzag collapse occurs with axial loading. A deformity with dorsiflexion of the lunate within the linkage (dorsiflexion instability) occurs commonly after scaphoid fracture and scapholunate dissociation. When dissociation occurs the scaphoid assumes a vertical position, that is, the angle formed by the longitudinal axes of the scaphoid and lunate approaches a right angle. Rupture of the distal ­attachments of the palmar radiocarpal ligament and of the scapholunate ­ligament appears to induce dissociation. It is therefore concluded that ligamentous injury along with scaphoid fracture is probably necessary if dorsi­flexion instability is to develop.
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