A mechanical comparison of bone-ligament-bone autografts from the wrist for replacement of the scapholunate ligament

Midterm Outcome of Bone-Ligament-Bone Graft and Dorsal Capsulodesis for Chronic Scapholunate Instability

“…17 This is in line with biomechanical studies that have shown that this type of graft is noticeably weaker than the dorsal part of the SLIL. 18 Cuénod et al 19 believed that a more appropriate substitute should be hand-based and intercarpal. A mechanical comparison of BLB autografts from the wrist found the trapezoidetoesecond metacarpal ligament and the capitate-to-trapezoid are appropriate substitutes for the dorsal SLIL.…”

“…A mechanical comparison of BLB autografts from the wrist found the trapezoidetoesecond metacarpal ligament and the capitate-to-trapezoid are appropriate substitutes for the dorsal SLIL. 19 The advantages proposed for these grafts were an easy harvest by the same surgical approach; the size, type, load to failure, and stiffness matches those of the dorsal part of the SLIL; and functionally minimal donor site morbidity. Since 1997, we have treated a series of patients with these BLB grafts reinforced with a distally based dorsal capsulodesis.…”

Chronic Scapholunate Ligament Injury

“…37,40 Proponents of this technique suggest that bone-to-bone healing may be more predictable than ligamentto-bone healing. Pitfalls associated with bonetissue-bone grafts include (1) stretch of the tissue portion of the graft over time, (2) failure of the graft to incorporate because of a tenuous proximaldorsal blood supply of both the scaphoid and lunate, and (3) failure to address the rotatory subluxation of the scaphoid in static dissociation.…”

Die Behandlung der veralteten skapholunären Dissoziation mittels eines Knochen-Band-Knochen-Transplantats nach Cuénod

“…Harvey et al [9] konnten in einer experimentellen Studie zeigen, dass sowohl das Band zwischen Os metacarpale III und Os capitatum als auch das Band zwischen Os metacarpale II und Os trapezoideum in ihren mechanischen Eigenschaften, wie Reißfestigkeit und Elastizität, und in ihren Dimensionen dem dorsalen Anteil des skapholunären Bandes weitgehend entsprachen, im Gegensatz zum Knochen-Retinakulum-KnochenTransplantat, das bedeutend schwächer war. Cuénod et al [5] konnten diese Ergebnisse in einer weiteren experimentellen Studie bestätigen. Klinisch verwendete Harvey in der Folge das Karpometakarpalgelenk-IIITransplantat, wobei eine exakte Ergebnisanalyse bislang nicht veröffentlicht wurde.…”