Arthroscopic Scapholunate Capsuloligamentous Repair: Suture With Dorsal Capsular Reinforcement for Scapholunate Ligament Lesion

Carratalá, Vicente; Lucas, Francisco Javier; Miranda, I.; Alepuz, Eduardo Sánchez; Jofré, Christian González

doi:10.1016/j.eats.2016.09.009

Cited by 26 publications

(20 citation statements)

References 16 publications

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“…In our series, the cases that required a second surgery due to a poor outcome with the initial suture and symptomatic instability of the carpus corresponded to patients who were treated at a later stage, 31 and 48 days after onset of the injury, probably related to loss of healing capacity after the first week, whereby we believe that treatment of acute injuries in the first 2 to 3 weeks 22 gives good results with regard to pain, grip strength, motion, and functional outcomes (►Fig. 11).…”

Section: Discussionmentioning

confidence: 78%

“…This technique can be performed on acute isolated injuries of the SLL and those associated with distal radius fractures. 22 This technique is not indicated for chronic lesions or nonreducible instability.…”

Section: Arthroscopic Suturing Of the Sllmentioning

confidence: 99%

“…Four weeks postoperatively, after removing the forearm splint, the patient starts specific rehabilitation treatment. 22…”

Section: Postoperative Periodmentioning

confidence: 99%

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Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

et al. 2020

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Objective To describe a technique for treating acute injuries of the scapholunate ligament (SLL) by performing an arthroscopic reinsertion of the SLL and dorsal capsulodesis and to present the results obtained. Methods The study deals with an analytical, prospective clinical study that included 19 consecutive patients with acute injury of the SLL. The range of joint motion, grip strength, pain according to the visual analog scale, functional outcomes according to the Mayo Wrist Score (MWS), and the QuickDASH Score were studied preoperatively and 6 and 12 months postoperatively. The complications and necessary reinterventions were recorded. Results Nineteen patients with acute injury of the SLL were studied; mean age was 44 ± 2 years, 74% males, 58% complete rupture, and 42% partial rupture, treated with the above-mentioned technique. Thirty-seven percent also had a distal radius fracture and there was one case of perilunate dislocation. Improvement in pain, grip strength, joint balance, and functionality was observed 6 and 12 months postoperatively, with 79% of the cases with good or excellent results Conclusion The arthroscopic reinsertion and dorsal capsular reinforcement of the SLL, allow a reliable and stable primary repair of the dorsal aspect of the ligament in acute or subacute SL injuries where there is tissue that can potentially be repaired, thus achieving an anatomical repair similar to that obtained with open surgery, but without the complications and stiffness secondary to aggressive interventions on the soft tissues that are inherent to the open dorsal approach.

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Section: Discussionmentioning

confidence: 78%

Section: Arthroscopic Suturing Of the Sllmentioning

confidence: 99%

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Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

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“…La reparación completa del desgarro del LEL se muestra en una muñeca izquierda. 18 Fig. 15 Esquema de procedimiento para reparación indirecta del LEL (InternalBrace): todos los procedimientos de artroscopia y fluoroscopia intraoperatoria mostraron túneles óseos y FRD tratada con placa de gancho dorsal para fijación del labio dorsal cubital y dos tornillos de compresíón sin cabeza para fracturas del estiloides radial/cubital.…”

Section: Resultsunclassified

Arthroscopic Management of Intra-articular Ligament Lesions on Distal Radius Fractures

Aita

Kaempf²,

Biondi

et al. 2021

Revista Iberoamericana de Cirugía de la Mano

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Articular distal radius fractures (DRFs) have increased in incidence in recent years, especially among the economically active population. Most of the treatment approaches are based on plain X- rays, and do not give us any information on how to treat these fractures. In the search for solutions with greater precision in diagnosis, in reducing the joint surface of the fracture, and envolving minimally-invasive techniques, we found arthroscopy as the main tool for these patients. Therefore, an enhanced understanding of the biomechanics of the different types of fracture associated with ligamentous lesions should facilitate the right decision regarding the treatment. The present paper aims at providing a management-oriented concept to diagnose and treat ligamentous lesions associated with intra-articular DRFs based on a arthroscopy-assisted procedure, and showing the objective and patient-reported outcomes and a new classification. The objective and patient-reported outcomes were: the mean range of motion (ROM) was of 94.80% on the non-affected side; the mean score on the abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH) was of 3.6 (range: 1 to 12). The score on the Visual Analog Scale (VAS) was of 1.66 (range: 1 to 3). Complications were observed in 2 (13.33%) patients: extensor tendon synovitis in 1 patient, and a limitation (stiffness) in ROM in 1 patient, both treated with wrist arthroscopy release. The mean time until the return to work was of 6.4 weeks. In patients with unstable intra-articular DRFs associated with ligamentous lesions, the fixation of specific osseous-ligamentous fragments and ligamentous repair/reconstruction by wrist arthroscopy prove to be a safe and reliable treatment. The clinical and functional results predict that the patients can return to work more quickly.

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“…2 Since their review, further techniques have been described or reported upon without the emergence of a gold standard. 11,12 Graft choice, like reconstructive technique, is dependent on surgeon preference. Yet, the properties of the graft may have a notable impact on the outcome of the reconstruction.…”

Section: Current Treatment Modalitiesmentioning

confidence: 99%

Ligamentization and Remnant Integration: Review and Analysis of Current Evidence and Implications for Scapholunate Reconstruction

2020

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Background Scapholunate interosseous ligament injuries are common but remain a therapeutic challenge. Current treatment modalities prioritize restoration of normal anatomy with reconstruction where appropriate. To date no reconstructive technique has been described that discusses the potential benefit of preservation of the scapholunate ligament remnant. Little is known about the “ligamentization” of grafts within the wrist. However, a growing body of knee literature suggests that remnant sparing may confer some benefit. In the absence of wrist specific studies, this literature must guide areas for potential augmentation of current surgical practices. Objective The purpose of this study was to perform a review of the process of ligamentization and a systematic review of the current literature on the possible role of ligament sparring and its effect on ligamentization. Methods A systematic search of the literature was performed to identify all the studies related to remnant sparing and the ligamentization of reconstructed tendons, regardless of graft type or joint involved from MEDLINE, EMBASE, and PubMed until February 1, 2016 using the following keywords: ligamentization, graft, remodelling, reconstruction, biomechan*, histolo∗, scapholunate ligament. Each selected study was evaluated for methodological quality and risk of bias according to a modified Systematic Review Center for Laboratory Animal Experimentation criteria. Conclusions The available literature suggests that ligament sparring demonstrated a trend toward improvements in vascularity, mechanoreceptors, and biomechanics that lessens in significance over time. Clinical Relevance This review suggests that remnant sparing may be one way to improve outcomes of scapholunate ligament reconstructive surgery. Level of Evidence This is a level I/II, review study.

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Arthroscopic Scapholunate Capsuloligamentous Repair: Suture With Dorsal Capsular Reinforcement for Scapholunate Ligament Lesion

Cited by 26 publications

References 16 publications

Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

Arthroscopic Management of Intra-articular Ligament Lesions on Distal Radius Fractures

Ligamentization and Remnant Integration: Review and Analysis of Current Evidence and Implications for Scapholunate Reconstruction

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