Introduction: The scapholunate ligament (SLL) injury can cause wrist pain and instability. There is a wide variety of surgical techniques used for the treatment of this lesion, such as dorsal capsulodeses, tenodeses with flexor or extensor tendons, and bone-ligament-bone graft. Objective: To describe a new technique for the treatment of SLL injury aiming to stabilize the dissociated carpus with a double dorsal capsulodesis. Materials and methods: By presenting the case of a 36-year-old male security officer who injured his left wrist in a motorcycle accident, a procedure to align the carpus is proposed. The long-term outcome of this procedure is also described Results: The proposed surgery was successfully performed; it had excellent clinical and functional results, with no complications. Long-term restoration of carpal alignment observed in wrist radiographs was evidenced after two years of follow-up, the patient was asymptomatic and with full functional recovery. Conclusion: The proposed technique appears to be reproducible, effective and easy to perform. Unlike the technique described by Blatt, the aim of this one is to restore the physiological position of the lunate bone by adding a second capsulodesis, as it is believed to be an essential factor in the maintenance of carpal kinematics.

Objective To describe a new surgical technique and treatment outcomes of type II scaphoid nonunion advanced collapse (SNAC) lesions by scaphoid distal resection associated to the tenodesis of the remaining proximal pole with the extensor brevis carpi radialis tendon. Material and Methods This is a retrospective, observational study in which six patients were enrolled and submitted to this original technique, from February 2016 to March 2018. Only those patients with a comprehensive assessment and minimum 6 months postoperative evolution were included. Patient data, such as age, gender, and dominance, along with injury characteristics, previous therapies, complaints, and time span between appearance of the lesion and surgery were all analyzed. Results Among the six patients assessed, four were male, with ages ranging from 28 and 46 years (mean, 38.1 years). The elapsed time between nonunion diagnosis or scaphoid fracture and definitive treatment ranged from 34 to 72 months, with an average of 48.0 months. The mean follow-up time between the surgery and final results assessment was 15.3 months, ranging from 8 to 22 months. Preoperative measured mean pain was 8.8, ranging from 8 to 10. At 6 months postoperatively, mean pain assessment was 1.5, ranging from 0 to 5. We added wrist flexion and extension to assess joint range of motion. Preoperatively, the mean measure was 76.6°, ranging from 55° to 90°. Postoperatively, the mean was 127.1°, ranging from 110° to 140°. One patient had proximal scaphoid necrosis at 8 months postoperatively as a complication. The patient was treated with proximal carpectomy, with good clinical outcome; however, he did not return to his original job activities. The other five patients did return to their previous labor activities. Conclusions Treatment of type II SNAC lesions by resection of the distal scaphoid associated to tenodesis of the remaining proximal pole with a portion of the extensor brevis carpi radialis tendon has proved to be a useful, safe technique. Having low morbidity and few complications, the treatment represents a good alternative to previously described techniques.