Arthroscopic Dorsal Ligamentocapsulodesis in the Treatment of Isolated Lunotriquetral Interosseous Ligamentous Injury: A Retrospective Case Series of 22 Patients

Abstract

Background: The literature is scarce regarding isolated tears of lunotriquetral interosseous ligament (LTIL). The purpose of this study was to present mid-term clinical and functional results of arthroscopic dorsal ligamentocapsulodesis in the treatment of isolated LTIL tears. Methods: Twenty-two patients (8 females, 14 males; mean age: 31 years; age range: 18–42) with isolated LTIL tears verified by wrist arthroscopy were retrospectively reviewed and included in the study. The mean follow-up was 55 months (range: 24–84). The modified Mayo wrist score, visual analog scale (VAS), flexion and extension deficits of passive wrist range of motion (ROM), pain-free ROM with forced wrist extension and grip strength were measured in all patients preoperatively and at final follow-up. Results: The mean modified Mayo wrist score significantly improved from 50 ± 10.29 preoperatively (range: 30–65) to 86 ± 11.61 (range: 60–100) at the final follow-up (p < 0.001). The mean VAS score significantly improved from 7.1 ± 0.83 (range: 6–8) preoperatively to 2.2 ± 1.35 (range: 0–6; p < 0.001) at the final follow-up. At the final follow-up examination, the forced wrist extension was painless in all but three patients who developed pain at 70º, 75º and 80º of extension, respectively. The mean strength of hand grip significantly increased from 38.6 ± 9.68 (range: 24–54) kg to 49.5 ± 12.36 (range: 33–66) kg at the final assessment (p < 0.001). No major complications were observed during or after the procedure. Conclusions: With the encouraging mid-term outcomes and a lower complication rate, arthroscopic LTIL dorsal ligamentocapsulodesis seems to be a safe and effective surgical technique in improving functional outcomes and reducing pain in patients with isolated LTIL tears. Level of Evidence: Level IV (Therapeutic)

Arthroscopic Repair of Combined Triangular Fibrocartilage Complex, Lunotriquetral Ligament, and Ulnocarpal Ligament Tears

“…In patients without injury, this should not be easily achievable. Our observations further suggest that despite some articles describing favorable outcomes of dorsal capsuloligamentous LTIL repair, 11 , 12 volar capsular or UCLC plication also can play a role in stabilizing the LT joint. This observation is particularly relevant, considering the stronger nature of the volar LTIL ligament when compared with its dorsal counterpart.…”

“… 10 Surgical treatments for UTq and LTIL tears have been documented; however, these treatments do not address concurrent PRUL or palmar TFCC tears. 5 , 11 , 12 We describe a simple technique of arthroscopic ulnocarpal ligament plication for combined palmar TFCC and LTIL tears.…”

Dorsal Intercarpal Ligament Tears: An Arthroscopic Classification and Clinical Outcomes Study

“…12,22,23 LT ligament injuries have also been treated with dorsal capsulodesis with favorable outcomes. [24][25][26] Although this technique has not been described for floating lunate (combined SLIL and LTIL injuries) 27 or perilunate-type injuries, DICL capsulodesis or plication can theoretically be applied to them.…”

Reverse Wafer Procedure for Ulnar Impaction Syndrome

“…If scapholunate or LT injury caused carpal instability, dorsal ligamentocapsulodesis is performed. 19,20 The dorsal ligamentocapsulodesis was described by Mathoulin et al 21 to reduce back and repair the dorsal capsular detachment together with the LT ligament tear. The sutures are passed through the dorsal capsule and remnants of the intrinsic ligament through the 3 to 4 radiocarpal portal, then retrieved in the midcarpal joint, externalized, tied to themselves at the radial midcarpal portals and reinserted.…”

“…Midcarpal examination was also performed over the ulnar midcarpal viewing portal to look for the integrity of the scapholunate and LT ligaments. If scapholunate or LT injury caused carpal instability, dorsal ligamentocapsulodesis is performed 19,20 …”