Original CommunicationsLong-term results after repair and augmentation ligamentoplasty of rotatory subluxation of the scaphoid*,**
Section snippets
Materials and methods
This study represents a retrospective follow-up analysis of 22 cases of surgically treated chronic dynamic (n = 7) or static (n = 15) SL instability at a single institution. Patients were included in the study and defined to have a chronic instability when clinical symptoms and signs were persistent or increased for at least 4 weeks or more after the trauma.
Subjective findings
Patients' subjective ratings of pain were as follows: 13 reported no pain, clicking, or aching, and 6 had occasional mild symptoms like dorsal wrist pain after or during strenuous activities but without limitation of their working ability or daily activities. Three patients had moderate pain with certain functional limitations. No patient reported notable or severe pain.
Occupation and working activities: 16 patients were unimpaired, 3 had moderate impairment, and 3 had to change their activity
Discussion
Scapholunate dissociation is the most common instability pattern of the wrist and can lead, if untreated, to degenerative arthritis of the radiocarpal and later of the midcarpal joint.4, 11, 20, 21, 22, 23 The pattern of degeneration can be explained by the different nonspherical surfaces of the concerned joints.4, 24, 25, 26, 27 Therefore different classifications and indications for correction of carpal instability are reported,6, 19 and different modes of repair and/or reconstruction of the
References (47)
Capsulodesis in reconstructive hand surgery. Dorsal capsulodesis for the unstable scaphoid and volar capsulodesis following excision of the distal ulna
Hand Clin
(1987)Management of chronic rotary subluxation of the scaphoid by scapho- trapezio-trapezoid arthrodesis. Rationale for the technique, postoperative changes in biomechanics, and results
Hand Clin
(1987)- et al.
Treatment of scapholunate dissociation by ligamentous repair and capsulodesis
J Hand Surg
(1992) - et al.
Scapholunate ligament repair using the Mitek bone anchor
J Hand Surg
(2000) - et al.
Dorsal intercarpal ligament capsulodesis for scapholunate dissociation: biomechanical analysis in a cadaver model
J Hand Surg
(1999) - et al.
The dorsal ligaments of the wrist: anatomy, mechanical properties, and function
J Hand Surg
(1999) - et al.
The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis
J Hand Surg
(1984) - et al.
Bilateral scapholunate dissociation with degenerative arthritis
J Hand Surg
(1981) - et al.
Rotary subluxation of the scaphoid: a spectrum of instability
J Hand Surg
(1993) - et al.
Degenerative disorders of the wrist
J Hand Surg
(1985)
The effect of rotatory subluxation of the scaphoid on radio-scaphoid contact
J Hand Surg
Load transfer characteristics of the wrist. Part II. Perilunate instability
J Hand Surg
Treatment of carpal instability without joint fusion—current assessment
J Hand Surg
Scapholunate ligament repair and capsulodesis for the treatment of static scapholunate dissociation
J Hand Surg
Early results of a modified Brunelli procedure for scapholunate instability
J Hand Surg
Management of post-traumatic instability of the wrist secondary to ligament rupture
J Hand Surg
Open reduction of carpal dislocations: indications and operative techniques
J Hand Surg
Dynamic scapholunate instability: results of operative treatment with dorsal capsulodesis
J Hand Surg
Autografts from the foot for reconstruction of the scapholunate interosseous ligament
J Hand Surg
Tarsal autografts for reconstruction of the scapholunate interosseous ligament: a biomechanical study
J Hand Surg
Coincident rupture of the scapholunate and lunotriquetral ligaments without perilunate dislocation: pathomechanics and management
J Hand Surg
Scapholunate ligamentous instabilities (dissociations, subdislocations, dislocations)
Ann Chir Main
A dynamic biomechanical study of scapholunate ligament sectioning
J Hand Surg
Cited by (46)
Outcomes of Acute Versus Subacute Scapholunate Ligament Repair
2022, Journal of Hand Surgery Global OnlineInternal Bracing Augmentation for Scapholunate Interosseous Ligament Repair: A Cadaveric Biomechanical Study
2020, Journal of Hand SurgeryOpen Treatment of Acute Scapholunate Instability
2015, Hand ClinicsCitation Excerpt :Results of primarily chronic repair range from poor to excellent in these reports (Table 3). In addition to the articles found in the Chennagiri and Lindau41 review, another article47 reported on chronic repair of SLIL injury. Here, 22 patients were treated with a transosseous suture technique in the chronic setting.
Diagnosis and Treatment of Chronic Lunotriquetral Ligament Injuries
2015, Hand Clinics
- *
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
- **
Reprint requests: Andreas Schweizer, MD, Orthopädische Klinik, Kantonsspital Liestal, Rheinstrasse 26, 4410 Liestal, Switzerland.