Clinical Research Directory

Comparison of Strength, Weight Bearing, Proprioception, Reaction Time and Function in Scapholunate Instability

Scapholunate (SL) instability is the most common type of instability seen in the wrist, resulting from SLI injury or excessive mobility \[1,2\]. It usually occurs after trauma and can range from mild injury to severe malalignment \[3\]. Symptoms include dorsal pain, clicking sound, limited movement, increased pain with weight-bearing, and weakness \[4,5\]. Pain reduces joint movement and grip strength, limiting daily activities \[6\]. If there is no dislocation, conservative treatment (education, exercise, splinting) is applied \[7\]. The wrist absorbs and transfers load through ligaments. During flexion-extension, the scaphoid and lunate follow the capitate \[10\]. SLIL injuries alter forearm muscle activation. EKRL, EKRB, APL, and FKR are "scapholunate-friendly" muscles; EKU is not recommended due to its pronator effect \[12-15\]. SLIL mechanoreceptors enhance dynamic stability \[11,19\]. There are no studies objectively measuring the strength of these muscles. Isokinetic muscle assessment has not been performed in SL instability. These measurements objectively determine muscle strength and imbalances, personalizing treatment. Weight transfer capacity, reaction time, and proprioception have also not been studied. However, weight transfer is an indicator of stability, proprioception is critical for functionality, and reaction time reflects neuromuscular response speed \[23-27\]. The aim of this study is to compare forearm isokinetic muscle strength, grip strength, weight transfer, proprioception, reaction time, and functionality in individuals with SL instability with those in healthy individuals.

Diagnosing Dynamic Scapholunate Instability with Computer Tomography

Scapholunate instability can result in debilitating pain, dysfunction, and secondary arthritis. If treatment is required, the instability should ideally be addressed in the dynamic stage, before non-reducible non-repairable deformation occurs. Early diagnosing of instability of the scapholunate joint can be a complex task. In this study, the use of computer tomography (CT) scan is evaluatedto reveal the dynamic characteristics of the scapholunate instability. A CT-scan will be performed of the non-stressed wrist and a CT-scan under loading to potentially visualize increase of dorsal scaphoid translation, which is considered as primary cause of dorsoradial radioscaphoid pain in the early stage of scapholunate instability.