Year Book: Roentgenographic Examination of the Wrist: A Systematic Study of

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the Normal, Lax and Injured Wrist. Part 2: Stress Views. Schernberg, F. Abstract/Commentary:|1992 Year Book of Hand Surgery. Article 9-7.|Original Article:|J Hand Surg. 1990. 15-B. pp 220-228.. Background.--A previous trial examined the standard views of normal, lax, and traumatic wrists. This investigation systematically examined the same types of wrists with positional and stress views. Methods.--Fifty-three normal wrists, 15 lax wrists, and 80 injured wrists were examined roentgenographically while under normal or abnormal stress. Lateral (Fig 9-6) and postero-anterior views were taken of the normal wrists for comparison. Results.--Two types of wrist laxity were defined by stress examination. The first, found in 2 patients, was radiocarpal laxity. In 13 other patients, a second type of laxity was observed. Ten of these patients had evidence of ganglion cysts, and 3 were without symptoms. Because the laxity was located at the lunocapitate and lunotriquetral joints, it was termed perilunar laxity. In the injured wrists, stress examinations, particularly abnormal stress views, disclosed many abnormalities not seen on normal standard views or positional views. Most of these injuries were surgically confirmed and corrected. There were no false positive appearances. Conclusions.--This trial indicates the importance of roentgenographic examination of the wrist under stress. Ligamentous lesions and fractures of the carpal bones thereby can be revealed when they are not in evidence on standard or positional views. However, stress studies were not helpful in the area of the distal radioulnar joint.