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Concepts and Artistry in the Treatment of Scapholunate Ligament Injuries.

ABSTRACT: BACKGROUND:Scapholunate ligament injuries are highly challenging injuries to treat. Great uncertainly remains in determining which operative procedures are most effective. Furthermore, there is no consensus on whether surgical intervention changes the natural course of scapholunate injuries. METHODS:The authors present their assessment of scapholunate injuries and the senior author's preferred surgical techniques. Surgical videos are included. The authors' postoperative management is described. RESULTS:Operative procedures are selected based on the patient's timing and pattern of injury, degree of associated carpal changes and arthritis, and goals. CONCLUSION:Over the past 20 years, the senior author has had good success with these techniques, but prospective, longterm outcome studies are needed to critically assess whether these surgical techniques improve patients' long-term function and pain.

SUBMITTER: Elzinga KE

PROVIDER: S-EPMC6113079 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Concepts and Artistry in the Treatment of Scapholunate Ligament Injuries.

Elzinga Kate E KE Kamnerdnakta Sirichai S Chung Kevin C KC

Plastic and reconstructive surgery 20180901 3

<h4>Background</h4>Scapholunate ligament injuries are highly challenging injuries to treat. Great uncertainly remains in determining which operative procedures are most effective. Furthermore, there is no consensus on whether surgical intervention changes the natural course of scapholunate injuries.<h4>Methods</h4>The authors present their assessment of scapholunate injuries and the senior author's preferred surgical techniques. Surgical videos are included. The authors' postoperative management ...[more]

PMID: 29927837

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Project description:PurposeTreatment of subacute and chronic static scapholunate instability remains challenging. We aimed to determine 5- to 10-year outcomes of dorsal intercarpal ligament capsulodesis with scapholunate interosseous ligament repair for subacute and chronic static scapholunate instability.MethodsSix patients with subacute and chronic static scapholunate instability underwent dorsal intercarpal ligament capsulodesis with scapholunate interosseous ligament repair between 2011 and 2015, and 5 of them were followed for at least 5 years after surgery. The clinical and radiological results were retrospectively investigated. All patients were male, and the mean age at surgery was 37 years (range, 21-47 years). The mean period from injury to surgery was 26.2 months (range, 2-113 months). The surgical procedure was a modification of a method reported by Szabo et al.ResultsThe mean postoperative follow-up period was 8.1 years (range, 5.1-9.5 years). Median Disabilities of the Arm, Shoulder, and Hand and Mayo wrist scores improved from 23.3 to 1.7 and from 55 to 80, respectively, from before surgery to the final follow-up. Although the median flexion angle tended to be smaller, the median extension angle tended to be greater than before surgery. The median percent grip strength increased from 72.3% before surgery to 99.2% at the final follow-up. The median scapholunate gap improved from 4.2 mm before surgery to 2.1 mm at the final follow-up. The median scapholunate angle also improved from 95.7° before surgery to 71.3° at the final follow-up. Osteoarthritic changes were observed in 2 of 5 patients at the final follow-up.ConclusionsThe scapholunate gap in all patients was within the normal range after a mean of 8.1 years of follow-up. Dorsal intercarpal ligament capsulodesis with scapholunate interosseous ligament repair is considered a good alternative for subacute and chronic static scapholunate instability based on these 5- to 10-year outcomes.Type of study/level of evidenceTherapeutic IV.

Dataset Information

Concepts and Artistry in the Treatment of Scapholunate Ligament Injuries.

Publications

Concepts and Artistry in the Treatment of Scapholunate Ligament Injuries.

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