Abstract:We describe a technique of soft-tissue reconstruction which is effective for the treatment of chronic lunotriquetral instability. Part of extensor carpi ulnaris is harvested with its distal attachment preserved. It is passed through two drill holes in the triquetrum and sutured to itself. This stabilises the ulnar side of the wrist. We have reviewed 46 patients who underwent this procedure for post-traumatic lunotriquetral instability with clinical signs suggestive of ulnar-sided carpal instability. Standard r… Show more
“…1 In addition, because LT arthrodesis has variable outcomes and high complication rates, 10,26 authors have recently explored the soft tissue approach for treating LT instability by arthroscopic or open surgery. [11][12][13][14]17,27 Moskal et al 27 treated 20 patients with partial LT ligament tear using arthroscopic capsulodesis of the LT joint, with good results. Reagan et al 11 introduced ligament reconstruction using a distally based strip of the extensor carpi ulnaris tendon, in which simultaneous reconstruction of both dorsal and volar LT ligaments was possible.…”
Section: Discussionmentioning
confidence: 99%
“…The surgical treatment options for chronic LT instability include LT fusion, 7-10 ligament repair, 2,11 and reconstruction. [11][12][13][14] Shin et al 2 retrospectively reviewed 57 patients with chronic isolated LT injuries who had undergone 3 different procedures. Compared with ligament repair and reconstruction, LT fusion provided less satisfactory results and had a higher reoperation rate.…”
“…1 In addition, because LT arthrodesis has variable outcomes and high complication rates, 10,26 authors have recently explored the soft tissue approach for treating LT instability by arthroscopic or open surgery. [11][12][13][14]17,27 Moskal et al 27 treated 20 patients with partial LT ligament tear using arthroscopic capsulodesis of the LT joint, with good results. Reagan et al 11 introduced ligament reconstruction using a distally based strip of the extensor carpi ulnaris tendon, in which simultaneous reconstruction of both dorsal and volar LT ligaments was possible.…”
Section: Discussionmentioning
confidence: 99%
“…The surgical treatment options for chronic LT instability include LT fusion, 7-10 ligament repair, 2,11 and reconstruction. [11][12][13][14] Shin et al 2 retrospectively reviewed 57 patients with chronic isolated LT injuries who had undergone 3 different procedures. Compared with ligament repair and reconstruction, LT fusion provided less satisfactory results and had a higher reoperation rate.…”
“…2,5,10,16,20 Shahane and colleagues 20 examined 46 patients with chronic posttraumatic LT instability who underwent LT tenodesis with the ECU tendon. At a mean follow-up of 19 months, 19 patients had excellent and 10 had good results, but six patients had poor results and reported they would not undergo the procedure again if given the opportunity.…”
Section: Surgical Treatment Of Chronic Lunotriquetral Injuriesmentioning
confidence: 99%
“…A technique using a distally based ECU graft was introduced by Reagan and colleagues 5 and later modified by Shin and Bishop 16 and Shahane and colleagues. 20 Briefly, a dorsal approach to the wrist is used from the third through fifth extensor compartments, performing a ligament-sparing capsulotomy, and exposing the LT ligament (as described previously). After LT inspection, the lunate and triquetrum are reduced anatomically and stabilized with extra-articular K-wires.…”
“…A third alternative has been proposed by the colleagues at the Wrightington Hospital in UK. It consists of creating a vertical tether to the triquetrum, with a strip of ECU tendon passed through a bone tunnel on the dorsal aspect of the triquetrum, and triangular fi brocartilage [ 48 ] (Fig. 10.6 ).…”
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