Distal Tunnel Placement Improves Scaphoid Flexion With the Brunelli Tenodesis Procedure for Scapholunate Dissociation

Howlett, John; Pfaeffle, H. James; Waitayawinyu, Thanapong; Trumble, Thomas E.

doi:10.1016/j.jhsa.2008.08.022

Cited by 16 publications

(12 citation statements)

References 24 publications

(24 reference statements)

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“…In 2008, Howlett et al 38 compared distalexiting scaphoid tunnel placement with proximalexiting tunnel placement using Mersilene tape (Ethicon, Inc., Somerville, NJ) in place of the FCR tendon. After surgical reconstruction, the SL angle decreased to within 15°Ϯ 10°of the mean intact specimen for the proximal tunnel and 4°Ϯ 7°for the distal tunnel.…”

Section: Discussionmentioning

confidence: 99%

Radiographic Evaluation of the Modified Brunelli Technique Versus the Blatt Capsulodesis for Scapholunate Dissociation in a Cadaver Model

Pollock¹,

Sieg²,

Baechler³

et al. 2010

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Radiographic Evaluation of the Modified Brunelli Technique Versus the Blatt Capsulodesis for Scapholunate Dissociation in a Cadaver Model

Pollock¹,

Sieg²,

Baechler³

et al. 2010

The Journal of Hand Surgery

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“…The technique is called the "tri-ligament tenodesis" because it is intended to reconstruct the STT, dorsal SL, and dorsal radiotriquetral ligaments. Reprinted with permission from Howlett et al [26] Tunnels were placed centrally in the scaphoid starting at the volar distal pole and exiting either in the dorsal-distal pole (D) or in the dorsal-proximal pole at the scapholunate interval (P) under fluoroscopic guidance. Adapted with permission from Howlett et al [26] anchors.…”

Section: Stage 4: Complete Disruption With Irreparable Ligament and Rmentioning

confidence: 99%

“…Reprinted with permission from Howlett et al [26] Tunnels were placed centrally in the scaphoid starting at the volar distal pole and exiting either in the dorsal-distal pole (D) or in the dorsal-proximal pole at the scapholunate interval (P) under fluoroscopic guidance. Adapted with permission from Howlett et al [26] anchors. This technique restored anatomic relationships of the scaphoid and lunate while preserving passive motion in the cadaveric model.…”

Section: Stage 4: Complete Disruption With Irreparable Ligament and Rmentioning

confidence: 99%

Scapholunate Ligament Injuries: A Review of Current Concepts

Pappou

Basel

Deal

2013

Hand (New York, N,Y.)

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Injuries to the scapholunate ligament are common, especially among young active individuals. Surgeons are faced with a difficult problem because of imperfect surgical outcomes and the high demands of this patient population. Here, we review the current concepts and newest literature on scapholunate ligament injuries as well as the classification and treatment options for each stage of scapholunate instability. Emphasis is on stages in which reconstructive rather than salvage procedures can be performed. The natural history is poorly understood; it is unknown which and how many scapholunate injuries lead to wrist arthritis (SLAC wrist). Partial injuries are rare and in small studies did well with arthroscopic treatment. Complete injuries are graded based on the acuity of the injury, the presence and reducibility of scapholunate malalignment, and, finally, cartilage status. In acute injuries, anatomic repair usually leads to satisfactory results, and many authors augment the repair with a capsulodesis technique. In chronic injuries, the presence of static malalignment usually leads to inferior outcomes. Various techniques have been devised and improved over the years. These techniques appear to provide a more anatomic reconstruction, with less loss of motion; motion is 60-80 % of the contralateral side and grip strength averages 65-90 %. Once there is cartilage loss, the surgeon only has salvage procedures to choose from, tailored to the degree of arthritis.

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“…This scaphoid tunnel was determined to be the optimal position for preventing unwanted flexion of the scaphoid according to a biomechanical study of the modified Brunelli [25]. Each guidewire position is assessed under direct visualization and fluoroscopy to ensure adequate position prior to drilling over the wire (Figure 4).…”

Section: Volume 1 -Issue -3mentioning

confidence: 99%

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OPROJ

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Distal Tunnel Placement Improves Scaphoid Flexion With the Brunelli Tenodesis Procedure for Scapholunate Dissociation

Cited by 16 publications

References 24 publications

Radiographic Evaluation of the Modified Brunelli Technique Versus the Blatt Capsulodesis for Scapholunate Dissociation in a Cadaver Model

Radiographic Evaluation of the Modified Brunelli Technique Versus the Blatt Capsulodesis for Scapholunate Dissociation in a Cadaver Model

Scapholunate Ligament Injuries: A Review of Current Concepts

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