Plenary Session 4:
International Invited Guest Lecture: The Wrist: A New Perspective on Anatomy, Imaging and Reconstruction
This presentation will provide new concepts of anatomy of the wrist using cadaveric dissections, 4D CT Scans and arthroscopy.
There is variability in the morphology of the carpus with the Type I lunate creating a mono-articular midcarpal joint versus the Type II lunate creating a bi-condylar midcarpal joint. The ligaments have characteristic ways of attaching to the carpal bones.
The carpus is stabilized by a series of interlocking ligamentous rings. They provide stability of each bone throughout motion. Our kinematics and 4D CT studies demonstrate that the ligaments come into play in a sequential fashion4, 5. These sequential restraints provide stability in various aspects of each wrist motion. A failure of an individual ligament will lead to characteristic instability at the moment where the ligament is critical to the sequential restraint. Reconstruction of the carpal instability application of these sequential ligamentous restraints is critical to provide a functioning wrist6.
Each ligament and attachment forms an osteoligamentous unit. This is important for fractures of the distal radius. The ligaments remain attached to the fracture and determine the settling position of the fracture.
- Overview of the traditional understanding of the wrist anatomy, imaging and reconstruction.
- To provide a perspective on new concepts of anatomy using clinical, cadaveric, arthroscopic anatomy and imaging. This will include 4D CT scans.
- To apply this to the surgical application reconstruction.