A Method for Measuring Tension in Small Ligaments: An Application to the Ligaments of the Wrist Carpus

A new technique has been devised for measuring the in situ tension in small ligaments. It is based on measuring the tension in an axially loaded flexible cable with pinned endpoints by deflecting the cable laterally and measuring its lateral load and deformation. Studies were performed in which nylon line and bone ligament bone preparations were placed in a materials tester and loaded in axial tension. Axial load as measured by lateral load and deformation was found to agree with the known load to within 8 percent. The method was sensitive to error in determination of ligament length, nonperpendicularity of the laterally applied load to the long axis of the ligament, and when used in situ, impingement of the ligament on a third bone causing bending. A device, consisting of an LVDT mounted to a rigid frame with its core rod connected to a load cell, was developed. The position of the core rod was controlled by a manual screw drive, and a hook on the other end of the core rod was used to deflect the ligament laterally. This device was applied to the study of tensions in five ligaments of the palmar wrist carpus, in seven cadaver specimens. Results showed that the radioscaphocapitate (RSC) and radiolunate (RL) ligaments had significantly greater tensions than the lunotriquetral (LT), the triquetrocapitate (TC), and scaphocapitate (SC) ligaments. For the four positions of the hand tested, neutral, 14 deg radial and 14 deg ulnar deviation, and 28 deg of extension, ligament tensions were found to be unaffected by position. In all positions tested, all ligaments had measurable tension, demonstrating the importance of ligaments in maintaining the integrity of the wrist carpus.