Management of chronic rotary subluxation of the scaphoid by scapho-trapezio-trapezoid arthrodesis

Capsulodesis for the treatment of chronic scapholunate instability

“…Triscaphoid fusion was first described in 1967 by Peterson and Lipscomb 21 and has been shown to be an effective treatment option for chronic SL instability. [3][4][5]22,23 Long-term studies, however, revealed a complication rate of up to 52% with a high rate of radiocarpal arthrosis. 24,25 Novel tenodesis procedures and bone-ligament-bone constructs have been developed but more long-term follow-up evaluation is needed before general application of these procedures can be advocated.…”

Dynamic Repair of Scapholunate Dissociation With Dorsal Extensor Carpi Radialis Longus Tenodesis

“…2 Although the exact anatomic explanation for the occurrence of dynamic scapholunate instability remains unproved, it has been suggested that the etiology lies in the damage to the supporting ligaments of the scapholunate joint, including the scapholunate interosseous ligament, the radial collateral ligament, and the palmar radioscapholunate ligament. [3][4][5] Consequently, the scaphoid becomes unstable with marked volar flexion of the distal scaphoid pole and subluxation of the proximal portion over the dorsal tip of the radius.…”

Outcomes of Dorsal Capsulodesis and Tenodesis for Treatment of Scapholunate Instability

“…Several surgical procedures have been recommended for the treatment of this disease process including arthrodesis (scaphotrapezial and scaphocapitate), capsulodesis alone, ligament repair in conjunction with dorsal capsulodesis, tenodesis, and bone-ligamentbone reconstruction. [1][2][3][4][5][6][7][8][9][10] If there is no evidence for radiocarpal arthritis, soft-tissue procedures using either dorsal capsulodesis or tenodesis may be executed in an attempt to preserve radiocarpal and intercarpal motion while avoiding fusion. Capsulodesis and tenodesis also may limit scaphoid flexion, which may prevent further rotatory subluxation and progression to radiocarpal arthritis.…”