Chronic Scapholunate Ligament Injury

Michelotti, Brett; Adkinson, Joshua M.; Chung, Kevin C.

doi:10.1016/j.hcl.2015.04.013

Cited by 26 publications

(7 citation statements)

References 63 publications

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“…More recently, techniques including Corella [ 5 ] and scapholunate axis (SLAM) [ 3 ] involving either a multiplanar scaphoid-lunate tether or volar reconstruction in addition to dorsal have been proposed in order to overcome this. Although preliminary studies suggest that multiple junction point techniques are better able to correct SL gap and angle compared to conventional techniques, further data, analysis and long-term follow-up studies are required to confirm this [ 3 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the performance of three tenodesis techniques for the treatment of scapholunate instability: flexion-extension and radial-ulnar deviation

Alonso-Rasgado

Zhang

Jimenez-Cruz

et al. 2017

Med Biol Eng Comput

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Chronic scapholunate ligament (SL) injuries are difficult to treat and can lead to wrist dysfunction. Whilst several tendon reconstruction techniques have been employed in the management of SL instability, SL gap reappearance after surgery has been reported. Using a finite element model and cadaveric study data, we investigated the performance of the Corella, scapholunate axis (SLAM) and modified Brunelli tenodesis (MBT) techniques. Scapholunate dorsal and volar gap and angle were obtained following virtual surgery undertaken using each of the three reconstruction methods with the wrist positioned in flexion, extension, ulnar deviation and radial deviation, in addition to the ulnar-deviated clenched fist and neutral positions. From the study, it was found that, following simulated scapholunate interosseous ligament rupture, the Corella technique was better able to restore the SL gap and angle close to the intact ligament for all wrist positions investigated, followed by SLAM and MBT. The results suggest that for the tendon reconstruction techniques, the use of multiple junction points between scaphoid and lunate may be of benefit. Graphical abstractThe use of multiple junction points between scaphoid and lunate may be of benefit for tendon reconstruction techniques.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the performance of three tenodesis techniques for the treatment of scapholunate instability: flexion-extension and radial-ulnar deviation

Alonso-Rasgado

Zhang

Jimenez-Cruz

et al. 2017

Med Biol Eng Comput

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“…Several options for BLB transplants exist and are in clinical use. 23 , 24 The biomechanical properties of the first dorsal extensor compartment are comparable to those of the dorsal part of the SL ligament. 19 …”

Section: Discussionmentioning

confidence: 98%

Biomechanical Properties of First Dorsal Extensor Compartment Regarding Adequacy as a Bone-Ligament-Bone Graft

Jakubietz

Meffert

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Bone-ligament-bone grafts for reconstruction of the scapholunate ligament are a valuable tool to prevent disease progression to carpal collapse. Locally available grafts do not require an additional donor site. The first extensor compartment was evaluated biomechanically regarding its possible use as an autograft.Methods:Twelve native fresh-frozen, human cadaver specimens were tested by applying axial tension in a Zwick Roell machine. Load to failure, transplant elongation, and bony avulsion were recorded. The load to failure was quantitated in newtons (N) and the displacement in length (millimeters). Parameters were set at distinct points as start of tension, 1 mm stretch and 1.5 mm dissociation, failure and complete tear, and were evaluated under magnified visual control. Although actual failure occurred at higher tension, functional failure was defined at a stretch of 1.5 mm.Results:Mean load at 1 mm elongation was 44.1 ± 28 N and at 1.5 mm elongation 57.5 ± 42 N. Failure occurred at 111 ± 83.1 N. No avulsion of the bony insertion was observed. Half the transplants failed in the central part of the ligament, while the rest failed near the insertion but not at the insertion itself. Analysis of tension strength displayed a wide range from 3.8 to 83.7 N/mm at a mean of 33.4 ± 28.4 N/mm.Conclusions:The biomechanical tensile properties of the first dorsal extensor compartment are similar to those of the dorsal part of the scapholunate ligament. A transplant with a larger bone stock and a longer ligament may display an advantage, as insertion is possible in the dorsal, easily accessible part of the carpal bones rather than in the arête-like region adjacent to the insertion of the scapholunate ligament. In this study, 1.5 mm lengthening of the bone–ligament–bone transplant was defined as clinical failure, as such elongation will cause severe gapping and is considered as failure of the transplant.

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“…Since the classic article by Berger et al on the anatomic strength of the scapholunate interosseous ligament (SLIL), 1 much attention has been paid on repairing or reconstructing the dorsal part of the SLIL given its highest breaking strength. 2 3 4 Less emphasis has been paid to the volar SLIL, which yields approximately one-third the strength of its dorsal counterpart. Its repair may be indicated in European Wrist Arthroscopy Society (EWAS) stage IIIA or complete SLIL injuries (EWAS IIIC and IV).…”

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confidence: 99%

Clinical Outcomes of Arthroscopic-Assisted Volar Scapholunate Capsulodesis: A Case Series

Vaquette

2023

J Wrist Surg

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Purpose We have previously described arthroscopic-assisted volar scapholunate (SL) capsulodesis as an alternative technique for addressing volar SL interosseous ligament (SLIL) injuries. In this article, we report the outcomes of this procedure in a cohort of patients. Methods Postoperative outcomes including range of motion, grip strength, visual analog scale (VAS) pain score, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), and Mayo Wrist Score were assessed through a prospective review of six patients in a single center who underwent this procedure. Results Six patients (four male and two female) with a mean age of 43 ± 14 years were evaluated in the study. The mean duration of follow-up was 41 ± 17 weeks. Postoperative outcomes noted a reduction in VAS pain score from 8 before surgery to 0.7 postoperatively (p = 0.00004) and improvement in Mayo Wrist Score (42 preoperatively to 80 postoperatively; p = 0.001), grip strength (86% of contralateral side; p = 0.20), and flexion arc (81% of contralateral side; p = 0.08). QuickDASH was 20 ± 8 and Patient-Rated Wrist Evaluation score was 13 ± 2 at the last clinical follow-up. There was an improvement in SL gap (p = 0.03), SL angle (p = 0.11), and radiolunate angle (p = 0.15) measurements postoperatively. Conclusions The described arthroscopic-assisted volar SL capsulodesis in this study presents an alternative method to address volar SLIL pathology with positive short-term clinical outcomes. Clinical Relevance Arthroscopic-assisted volar SL capsulodesis may be considered in the treatment algorithm for volar SLIL injuries.

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Chronic Scapholunate Ligament Injury

Cited by 26 publications

References 63 publications

Evaluation of the performance of three tenodesis techniques for the treatment of scapholunate instability: flexion-extension and radial-ulnar deviation

Evaluation of the performance of three tenodesis techniques for the treatment of scapholunate instability: flexion-extension and radial-ulnar deviation

Biomechanical Properties of First Dorsal Extensor Compartment Regarding Adequacy as a Bone-Ligament-Bone Graft

Clinical Outcomes of Arthroscopic-Assisted Volar Scapholunate Capsulodesis: A Case Series

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