Begutachtung der SL- und LT-Band-Schäden

In terms of function, the wrist is a taut ring-like structure with a rotationally balanced lunate bone. The scaphoid and lunate bones as well as the lunate and triquetral bones are all joined by a U-shaped ligament, the three parts of which are strongest at the dorsal scapholunate (SL) ligament and the palmar lunotriquetral (LT) ligament. An SL- or LT-ligament rupture breaks down the ring-like structure. Due to torsional stability in the intercalated segment, DISI (dorsal intercalated segment instability) or PISI (volar intercalated segment instability) occur in the event of rupture of the LT and/or SL ligaments which, if left untreated, progress to carpal collapse. Static instability can be diagnosed radiologically, while diagnosis of dynamic instability requires cinematography, stress X-rays, magnetic resonance imaging or arthroscopy, the latter being the most reliable. The nature of the accident is also important in terms of an expert opinion, since there are only a few mechanisms which lead to rupture of the SL or LT ligaments. SL- and/or LT-ligament tears frequently occur as concomitant injuries in the case of distal radial or perilunar fractures, among other hand injury complexes.