Arthroscopic Debridement and Closed Pinning for Chronic Dynamic Scapholunate Instability

Darlis, N.A.; Kaufmann, Robert A.; Giannoulis, F.; Sotereanos, Dean G.

doi:10.1016/j.jhsa.2005.12.015

Cited by 75 publications

(45 citation statements)

References 27 publications

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“…Another option described in patients with Geissler grade III or IV tears is aggressive arthroscopic debridement down to bleeding bone and pinning [14]. Three of 11 patients required revision procedures and were deemed failures.…”

Section: Stage 3: Complete Disruption With Irreparable Ligament But mentioning

confidence: 99%

Scapholunate Ligament Injuries: A Review of Current Concepts

Pappou

Basel

Deal

2013

Hand (New York, N,Y.)

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Injuries to the scapholunate ligament are common, especially among young active individuals. Surgeons are faced with a difficult problem because of imperfect surgical outcomes and the high demands of this patient population. Here, we review the current concepts and newest literature on scapholunate ligament injuries as well as the classification and treatment options for each stage of scapholunate instability. Emphasis is on stages in which reconstructive rather than salvage procedures can be performed. The natural history is poorly understood; it is unknown which and how many scapholunate injuries lead to wrist arthritis (SLAC wrist). Partial injuries are rare and in small studies did well with arthroscopic treatment. Complete injuries are graded based on the acuity of the injury, the presence and reducibility of scapholunate malalignment, and, finally, cartilage status. In acute injuries, anatomic repair usually leads to satisfactory results, and many authors augment the repair with a capsulodesis technique. In chronic injuries, the presence of static malalignment usually leads to inferior outcomes. Various techniques have been devised and improved over the years. These techniques appear to provide a more anatomic reconstruction, with less loss of motion; motion is 60-80 % of the contralateral side and grip strength averages 65-90 %. Once there is cartilage loss, the surgeon only has salvage procedures to choose from, tailored to the degree of arthritis.

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Section: Stage 3: Complete Disruption With Irreparable Ligament But mentioning

confidence: 99%

Scapholunate Ligament Injuries: A Review of Current Concepts

Pappou

Basel

Deal

2013

Hand (New York, N,Y.)

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“…[21] Bu nedenle literatürde Geissler 1. ve 2. derece skafolunat bağ yırtıkları için artroskopik debridman ve kapsüler büzülme, Geissler 3. ve 4. derece yırtıkları için ise artroskopik debridman ve kapalı pinleme gibi teknikler tanım-lanmıştır. [22][23][24] Son yıllarda artroskopi ile skafolunat yırtıkları için dorsal ve palmar kapsüloligamentöz tamir teknikleri tanımlanmıştır. [8][9][10]25] Mathoulin ve ark.…”

Section: Discussionunclassified

Arthroscopic dorsal ligamento capsulodesis results in Geissler grade 2 and 3 scapholunate interosseous ligament injuries

Özçelık¹,

Uğurlar²,

Kabakas³

et al. 2015

Eklem Hastalik Cerrahisi

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ÖZ Amaç(dağılım 0°-5°), ekstansiyon açıklığı farkı ortalama 4.37° (dağılım 0°-15°) idi. Sağlam ekstremiteye göre ameliyat sonrası fleksiyon açıklığı farkı ortalama 1.71° (dağılım 0°-5°), ekstansiyon açıklığı farkı ortalama 1.09° (dağılım 0°-10°) idi. Sağlıklı ele göre ameliyat öncesi ve sonrası ortalama kavrama kuvveti sırasıyla %86 ve %94 idi. Ameliyat öncesi GAÖ puanı 6.59 (dağılım 4-9) iken, ameliyat sonrası GAÖ puanı 1.21 (dağılım 0-6) idi. Sonuç: Çalışma sonuçlarına göre, artroskopik dorsal ligamentokapsülodez ağrı ve hareket kısıtlılığının giderilmesinde ve kavrama kuvvetinin geri kazanılmasında etkili bir yöntemdir.Anahtar sözcükler: Karpal instabilite; bağ yaralanması; skafolunat; el bileği artroskopisi. ABSTRACTObjectives: This study aims to retrospectively evaluate results of arthroscopic dorsal ligamento capsulodesis in Geissler grade 2 and 3 scapholunate ligament injuries. Patients and methods: Thirty-two patients (20 males, 12 females; mean age 30.1 years; range 21 to 42 years) who were performed arthroscopic dorsal ligamento capsulodesis due to Geissler grade 2 and 3 scapholunate ligament injuries between February 2011 and July 2013 were included in this study. Mean duration between the onset of complaints and surgery was 13.7 (range 6-20) months. Joint ranges of motion were compared to wrist motions on the healthy side. Patients were evaluated postoperatively by Mayo Wrist Scoring Test. Pain was assessed by visual analog scale (VAS). Results: Mean follow-up period was 15.12 (range 6-24) months. According to Mayo Wrist Scoring Test, results were excellent in 20 patients, and good in 12 patients. Compared to the healthy extremity, preoperative mean flexion gap range was 2.18º (range 0º-5º), and mean extension gap range was 4.37º (range 0º-15º). Compared to the healthy extremity, postoperative mean flexion gap range was 1.71º (range 0º-5º), and extension gap range was 1.09º (range 0º-10º). Compared to the healthy hand, preoperative and postoperative mean grip strengths were 86% and 94%, respectively. While preoperative VAS score was 6.59 (range 4-9), postoperative VAS score was 1.21 (range 0-6). Conclusion: According to the study results, arthroscopic dorsal ligamento capsulodesis is an effective method for the elimination of pain and range of motion limitation, and recovery of grip strength.

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“…Chronic predynamic instability also has been treated with selective proprioceptive rehabilitation, arthroscopic debridement, or capsular shrinkage (Box 2). 20, 21 Whipple 22 determined that if patients were treated within 3 months of injury, 83% remained symptom free and maintained their reduction in up to 7-year follow-up.…”

Section: Treatment Predynamic Instabilitymentioning

confidence: 99%