Treatment of scapholunate ligament injury

Andersson, Jonny

doi:10.1302/2058-5241.2.170016

Cited by 70 publications

(54 citation statements)

References 47 publications

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“…[8] In such cases, a second resection procedure of the proximal carpal row may be required. [29] Therefore, the use of compression screw fixation for first-stage scapholunate fusion should be considered to avoid the scapholunate separation and carpal bone collapse. The scapholunate fusion procedure was first developed in 1945.…”

Section: Discussionmentioning

confidence: 99%

First-stage scapholunate fusion for the treatment of a chronic lunate dislocation

et al. 2019

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Rationale: Lunate dislocation is a rare injury to the wrist caused by high-energy trauma, and poor prognosis is often associated with missed initial diagnosis. To date, there is no consensus regarding an effective treatment plan for such cases. Patient concerns: Here, we describe the case of a 36-year-old man who presented with lunate dislocation following a delay in diagnosis of over 7 weeks, and further illuminate its diagnosis and treatment. Diagnosis: The diagnosis of chronic lunate dislocation was rendered. Interventions: The patient was treated using reduction via the dorsal approach brachial plexus anesthesia. After the reduction, a headless compression screw fixation was performed for first-stage scapholunate fusion, and Kirschner wire fixation of the lunate-triquetrum-hamate was used to stabilize the distal and proximal carpal rows. Outcomes: The patient was followed up for 1 year and showed wrist function recovered well; radiographic examination showed no lunate dislocation and successful scapholunate bony fusion. A satisfactory outcome was achieved. Lessons: The case study presented here provide evidence that performing an effective first-stage scapholunate fusion is recommended to achieve better therapeutic outcomes for a chronic lunate dislocation. Furthermore, this approach led to a good long-term clinical outcome in our case.

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Section: Discussionmentioning

confidence: 99%

First-stage scapholunate fusion for the treatment of a chronic lunate dislocation

et al. 2019

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“…In most cases (60%), the ligament is avulsed from either the scaphoid (40%) or lunate (20%). In these cases, the avulsion may be managed with open repair and internal fixation in acute cases (6). In 40% of scenarios, the ligament is teared in the mid-substance and can be repaired and pinned arthroscopically in acute cases (6).…”

Section: Classificationmentioning

confidence: 99%

“…Also, the injury is commonly misinterpreted as a wrist sprain by patients (2). Forty-three percent of intraarticular (IA) distal radius fractures (5) and 5% of wrist sprains are accompanied with scapholunate (SL) dissociation (2,6). Therefore, it should be considered as a possible diagnosis in the presence of wrist trauma (1).…”

Section: Introductionmentioning

confidence: 99%

Scapholunate Ligament Injury: Reviewing the Concept and the Challenges Ahead

Vosooghi¹,

Khajeh²,

Mortazavi³

2020

jost

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“…Scapholunate (SL) dissociation occurs when the scaphoid and lunate move excessively in relation to one another; it is caused by the injuring of the SL interosseous ligament (SLIL) and affects carpal instability . Often, SLIL injuries are not diagnosed or treated during an acute phase of injury because it can take 3 to 12 months after trauma before dynamic instability develops and the SL dissociation can be detected radiologically; additionally, in some cases, people may have a tear of the SLIL but not present clinical symptoms . SL instability has been reported to occur in approximately 5% of cases of wrist sprains and is believed to be as common as scaphoid fractures .…”

Section: Introductionmentioning

confidence: 99%

“…Often, SLIL injuries are not diagnosed or treated during an acute phase of injury because it can take 3 to 12 months after trauma before dynamic instability develops and the SL dissociation can be detected radiologically; additionally, in some cases, people may have a tear of the SLIL but not present clinical symptoms . SL instability has been reported to occur in approximately 5% of cases of wrist sprains and is believed to be as common as scaphoid fractures . Some authors have theorised that the effect on carpal instability after SLIL tear may be moderated by the bone geometry, which may help to explain why some patients go on to progressive instability whilst others do not .…”

Section: Introductionmentioning

confidence: 99%

Performance evaluation of surgical techniques for treatment of scapholunate instability in a type II wrist

Leonardo-Diaz

Alonso-Rasgado

Jimenez-Cruz

et al. 2019

Numer Methods Biomed Eng

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We investigated the performance of three tenodesis techniques, modified Brunelli, Corella, and scapholunate axis (SLAM) methods in repairing scapholunate interosseous ligament (SLIL) disruption for a type II wrist using finite element-based virtual surgery and compared the results with those of a previous investigation for a type I wrist. In addition, a comparison of the carpal mechanics of type I and type II wrists was undertaken in order to elucidate the difference between the two types. For the type II wrist, following simulated SLIL disruption, the Corella reconstruction technique provided a superior outcome, restoring dorsal gap, volar gap, and SL angle to within 3.5%, 7.1%, and 8.4%, respectively, of the intact wrist. Moreover, application of the ligament reconstruction techniques did not significantly alter the motion pattern of the type II and type I wrists. For the type I wrist, SLIL disruption resulted in no contact between scaphoid-lunate cartilage articulation, whereas for the type II wrist, some contact was maintained. We conclude that the Corella ligamentous reconstruction technique is best able to restore SL gap, angle, and stability following SL ligament injury for both type II and type I wrists and is able to do so without altering wrist kinematics. Our findings also support the view that type I wrists exhibit row behaviour and type II wrists column behaviour. In addition, our analysis suggests that the extra articulation between the lunate and hamate in a type II wrist may help improve stability following SL ligament injury. Novelty• No previous studies have assessed the performance of scapholunate ligament reconstruction techniques considering the two types (I and II) of wrist.• No previous studies have investigated wrist carpal mechanics both before and after disruption of the SL ligament based on lunate bone morphology.

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Treatment of scapholunate ligament injury

Cited by 70 publications

References 47 publications

First-stage scapholunate fusion for the treatment of a chronic lunate dislocation

First-stage scapholunate fusion for the treatment of a chronic lunate dislocation

Scapholunate Ligament Injury: Reviewing the Concept and the Challenges Ahead

Performance evaluation of surgical techniques for treatment of scapholunate instability in a type II wrist

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