Long-term Outcomes of Delayed Scapholunate Ligament Repair After Complete Rupture of the Ligament

Abstract

Treatment of isolated complete tear of the scapholunate ligament is challenging. The purpose of this study was to determine (1) whether delayed repair of only scapholunate ligament is an option without other reconstruction procedures and (2) whether functional outcomes are possible despite radiographic presence of arthritis. This study included patients who had complete ligament tear at exploration and underwent only scapholunate ligament repair without capsulodesis or tenodesis. Fifteen patients returned for clinical and radiographic examinations. Preoperatively, mean scapholunate gap was 2.9 mm and 4.58 mm on posteroanterior and tangential posteroanterior views, respectively. Postoperatively, the final mean gap was 2.5 mm and 3.9 mm on the posteroanterior and tangential posteroanterior views, respectively. The mean preoperative and final scapholunate angles were 74° and 72.6°, respectively. Seven patients had radiographic arthritis at final follow-up. Delayed scapholunate repair is possible after complete ligament tear. At long-term follow-up, clinical functional outcomes may not correlate with radiographic presence of degenerative arthritis. [ Orthopedics . 2021;44(3):e446–e453.]

Scapholunate Ligament Rupture and Coincident Fracture Proximal Pole Scaphoid Presenting Late with Osteonecrosis

“…Early identification of scapholunate dissociation is vital for timely management. An acute tear or avulsion is amenable to direct repair in the acute setting within 6 to 12 weeks 9 ; however, successful delayed repairs up to 6 months after injury has been documented in literature 10 . For chronic tears older than 6 months, the general consensus is to perform scapholunate reconstruction.…”