Antipronation Spiral Tenodesis—A Surgical Technique for the Treatment of Perilunate Instability

Chee, Kin Ghee; Chin, Andrew Y.H.; Chew, Ee Ming; García-Elias, Marc

doi:10.1016/j.jhsa.2012.09.007

Cited by 35 publications

(23 citation statements)

References 13 publications

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“…Many techniques have been proposed and are based upon controlling the scaphoid that assumes a position of flexion and pronation. 1,[6][7][8]10,[13][14][15]17,[19][20][21][22][23] Berger's detailed anatomic prosections noted that the SL ligament comprised of a dorsal, membranous, and volar region. The palmar ligament had a yield strength of 120 N compared with that of the dorsal ligament, which exhibited a breaking strength of 300 N. Given this, traditional techniques had concentrated on reconstructing the dorsal ligament only.…”

Section: Discussionmentioning

confidence: 99%

“…13 As such, there has been an increasing interest to address the volar SL ranging from volar capsulodesis 23 to circumferential grafts around the scaphoid and lunate. 24 As reported by Chee et al, 14 a strip of the flexor carpi radialis (FCR) tendon can be passed from volar to dorsal through the scaphoid and dorsal to volar through the triquetrum in an antipronation tenodesis to correct carpal malalignment. Ho et al 24 described an arthroscopic-assisted technique of reconstructing the volar and dorsal SL ligament using a palmaris longus graft.…”

Section: Discussionmentioning

confidence: 99%

“…To try and correct the torsional instability that may result from dorsal only repairs, recent techniques have been described that address both dorsal and volar SL ligaments. 14,15 The purpose of this study was to compare the biomechanical strength of a 360-degree tenodesis to one augmented Keywords ► internal brace ► scapholunate instability ► scapholunate reconstruction ► suture tape ► internal brace augmentation…”

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confidence: 99%

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Scapholunate Ligament Internal Brace 360 Tenodesis (SLITT) Procedure: A Biomechanical Study

2018

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Background Twelve paired fresh frozen cadaveric wrists were randomized to a 360-degree tenodesis repair group or the 360-degree tenodesis repair with an internal brace (suture tape) construct. Case Description The specimens were preloaded to 5 N and subsequently biomechanically loaded to failure, at a rate of 0.1 mm/s on a jig that allowed for axial load. The maximum load and mode of failure were recorded. Load to failure in the 360 tenodesis group with internal brace was 283.47 ± 100.25 N, compared with the 360 tenodesis group only, whose yield strength was 143.61 ± 90.54 N. The mode of failure within the internal brace construct was either through knot slippage, graft disruption, or bone separation from strength testing construct. The 360 tenodesis group tended to fail via graft slippage or graft rupture. Literature Review The management of scapholunate instability can be a difficult problem to treat. Traditionally, many of the surgical reconstructions have focused upon dorsal ligament reconstruction with Kirschner (K) wire fixation. This results in prolonged immobilization of the wrist with varied outcomes, in part due to the multiaxial instability that may persist due to concomitant volar ligament disruption. To address this instability, surgical techniques have been devised that address both the volar and dorsal ligament injuries. Clinical Relevance Scapholunate reconstruction with a 360-degree tenodesis and internal brace augmentation (SLITT procedure) provided superior biomechanical stability than tenodesis alone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Scapholunate Ligament Internal Brace 360 Tenodesis (SLITT) Procedure: A Biomechanical Study

2018

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“…In a recent paper, Chee et al 16 described a chronic perilunate injury, treated by trispiral tenodesis, that could also be consistent with a PLIND lesion that was missed at the acute stage.…”

Section: Discussionmentioning

confidence: 99%

Perilunate Injuries, Not Dislocated (PLIND)

Herzberg

2013

Jnl Wrist Surg

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Purpose We reviewed a series of equivalents of perilunate dislocations and fracture-dislocations (PLDs-PLFDs) in which there was no dislocation of the capitate from the lunate on the initial radiographs. We propose to include these injuries as a variant of perilunate dislocations that we have termed a perilunate injury, not dislocated (PLIND) lesion in a modified classification of perilunate injuries. Methods A review of the records of all acute perilunate injuries and displaced carpal fractures was done in a single-center university hospital wrist surgery unit over a 5-year period. All cases presenting at the acute stage with displaced fractures of scaphoid, lunate, triquetrum, or capitate along with scapholunate and/or lunotriquetral dissociation but no dislocation of the capitate from the lunate in the sagittal or coronal plane were reviewed and considered as PLIND lesions. Results We identified 11 patients with PLIND lesions. Three cases with clinical and radiological follow-up are presented. Discussion Equivalents of PLDs-PLFDs presenting without dislocation of the capitate from the lunate do exist. These injuries may be overlooked despite their severity. They require both osseous and ligamentous repair. Including them into an existing perilunate injuries classification highlights their recognition and enables a better understanding and treatment of both acute and chronic nondislocated perilunate injuries. Level of Evidence Level IV, retrospective case series.

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“…erilunate fracture dislocations (PFD) are rare carpal injuries, comprising of less than 10% of all wrist injuries, in addition the volar PFD accounts for less than 3%, and to our knowledge only a few cases have been previously reported [1][2][3][4] . Approximately 20% of perilunate injuries are misinterpreted on the initial radiographs, that frequently missed, and most of such cases are diagnosed weeks after the accident [5][6][7][8] . Nonsurgical treatment of these injuries has been shown to produce inferior results and early open reduction is recommended to achieve anatomic alignment of the carpal bones 4,8,9 .…”

Section: Introductionmentioning

confidence: 99%

Volar Perilunate Carpal Fracture Dislocation: A Case Report of Uncommon Injury Pattern

Akrawi¹,

Muradian²

2017

Basrah Journal of Surgery

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Carpal fracture dislocations are relatively uncommon category of wrist injuries that often easily unrecognized and can be difficult to treat. We report a case of missed volar perilunar fracture dislocation in a 16 year old boy, and was treated operatively 40 days after injury by open reduction with the repair of ligaments. The outcome was satisfactory despite of the delay in diagnoses and surgery.

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Antipronation Spiral Tenodesis—A Surgical Technique for the Treatment of Perilunate Instability

Cited by 35 publications

References 13 publications

Scapholunate Ligament Internal Brace 360 Tenodesis (SLITT) Procedure: A Biomechanical Study

Scapholunate Ligament Internal Brace 360 Tenodesis (SLITT) Procedure: A Biomechanical Study

Perilunate Injuries, Not Dislocated (PLIND)

Volar Perilunate Carpal Fracture Dislocation: A Case Report of Uncommon Injury Pattern

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