Management of Intercarpal Ligament Injuries Associated with Distal Radius Fractures

Desai, Mihir J.; Kamal, Robin N.; Richard, Marc J.

doi:10.1016/j.hcl.2015.04.009

Cited by 13 publications

(7 citation statements)

References 45 publications

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“…24 However, the difficulty of diagnosing isolated acute injuries means that in the majority of cases, treatment is performed when the acute phase has already passed. This handicap is different in cases of distal radius fractures treated with arthroscopic assistance, in which the percentage of associated injuries involving the SLL is high (16-40%) 25 and an adequate diagnosis could be made early on to proceed to a potentially more effective treatment.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

et al. 2020

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Objective To describe a technique for treating acute injuries of the scapholunate ligament (SLL) by performing an arthroscopic reinsertion of the SLL and dorsal capsulodesis and to present the results obtained. Methods The study deals with an analytical, prospective clinical study that included 19 consecutive patients with acute injury of the SLL. The range of joint motion, grip strength, pain according to the visual analog scale, functional outcomes according to the Mayo Wrist Score (MWS), and the QuickDASH Score were studied preoperatively and 6 and 12 months postoperatively. The complications and necessary reinterventions were recorded. Results Nineteen patients with acute injury of the SLL were studied; mean age was 44 ± 2 years, 74% males, 58% complete rupture, and 42% partial rupture, treated with the above-mentioned technique. Thirty-seven percent also had a distal radius fracture and there was one case of perilunate dislocation. Improvement in pain, grip strength, joint balance, and functionality was observed 6 and 12 months postoperatively, with 79% of the cases with good or excellent results Conclusion The arthroscopic reinsertion and dorsal capsular reinforcement of the SLL, allow a reliable and stable primary repair of the dorsal aspect of the ligament in acute or subacute SL injuries where there is tissue that can potentially be repaired, thus achieving an anatomical repair similar to that obtained with open surgery, but without the complications and stiffness secondary to aggressive interventions on the soft tissues that are inherent to the open dorsal approach.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

et al. 2020

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“…However, these are not always clinically relevant. Possibly, ligamentous healing takes place during the immobilization [ 4 , 18 , 19 ]. Nonetheless, some patients receive simultaneous open distal radius fixation and direct SLIL reconstruction [ 20 - 24 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Functional Outcomes of Scapholunate Diastases Associated Distal Radius Fractures: A 2-year Follow-Up Scapholunate Dissociation

Lans

Lasa²,

Chen

et al. 2018

TOORTHJ

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Background:The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures. However, it remains unclear what patients develop symptoms, making primary treatment of these injuries accompanying distal radius fractures remains questionable.Objective:The aim of this study was to evaluate the functional outcomes of patients with scapholunate diastasis associated with distal radius fractures.Methods:We evaluated 391 patients with a distal radius fracture. Using Computer Tomography (CT) scans the scapholunate interval was measured. We identified 14 patients with an SLD (>3mm) of the injured wrist, which underwent a CT-scan of the contralateral wrist. To evaluate the functional outcomes at a mean follow up of 136±90 weeks, we used the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) Score.Results:There were 8 patients with bilateral SLD and 6 patients with unilateral SLD. Five patients had a qDASH score of 0 and one patient showed a qDASH score of 18.2. The patient with a poor score had bilateral preexisting osteoarthritis of the wrist. No patient had additional surgery of the SLIL.Conclusion:In patients with distal radius fractures, more than half of the 14 patients with an SL gap on CT had widening on the contralateral side. It is therefore worthwhile to image the contralateral wrist before diagnosing a SLD. The patients with unilateral SLD should not be surgically treated at initial presentation because they may have good functional outcomes after a follow up of 2 years.

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“…30 Es frecuente observar en radiografías de fracturas de radio distal distasis del espacio escafosemilunar mayor de 3 mm; 31,32,33 sin embargo, no siempre es clínicamente relevante, tal vez debido a la cicatrización ligamentaria durante la inmovilización. 34,35,36,37 La artroscopía se ha convertido en una herramienta de uso frecuente para diagnóstico y tratamiento de patología de muñeca entre los cirujanos de miembro superior, es importante destacar que la curva de aprendizaje es exigente. Obdeijn y colaboradores.…”

Section: Inclinación Radialunclassified

Fracturas intraarticulares de radio distal: reducción bajo fluoroscopía versus asistencia artroscópica. Revisión sistemática

Allende-Nores¹,

Paganini²,

Gutiérrez-Olivera³

et al. 2020

Acta Ortopédica Mexicana

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Las fracturas intraarticulares de radio distal son un desafío terapéutico para el cirujano ortopedista. Hay estudios que avalan el uso de la fluoroscopía y otros promueven la artroscopia. Con este trabajo intentamos resumir la evidencia, para determinar si la asistencia artroscópica aporta beneficios adicionales para evitar incongruencias articulares en comparación con los resultados obtenidos bajo asistencia fluoroscópica. Material y métodos: Búsqueda sistemática de estudios prospectivos, retrospectivos, de cohortes, seguimiento, ensayos clínicos en PubMed, MEDLINE, Scopus, Scielo, Embase, Google Scholar y otras fuentes nacionales, incluyendo como palabras clave los términos: intraarticular distal radius fracture, wrist arthroscopy, arthroscopy, fluoroscopy. Los valores medios y desvíos estándar para cada característica, obtenidos de los trabajos seleccionados fueron analizados usando estadística descriptiva y gráficos ilustrativos. Resultados: Fueron evaluados 463 pacientes (256 mujeres y 207 hombres), con una edad promedio de 48.29 años y rango de 39 a 64 años. Los dos tratamientos (A y F) fueron homogéneos en cuanto a la edad de los pacientes que reportan (p = 0.5820) y el tiempo de seguimiento promedio (p = 0.9597). Sólo la desviación cubital y el DASH, para las cuales el grupo de artroscopía tuvo mejor desempeño, en las variables restantes las diferencias no fueron significativas. Conclusión: La evidencia disponible hasta la fecha es controvertida y no permite hacer recomendaciones a favor o en contra de estas intervenciones, encontrando otros factores que podrían influir en la toma de decisiones.

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Management of Intercarpal Ligament Injuries Associated with Distal Radius Fractures

Cited by 13 publications

References 45 publications

Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results

Incidence and Functional Outcomes of Scapholunate Diastases Associated Distal Radius Fractures: A 2-year Follow-Up Scapholunate Dissociation

Fracturas intraarticulares de radio distal: reducción bajo fluoroscopía versus asistencia artroscópica. Revisión sistemática

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