Lunotriquetral Ligament Tears

Atkinson, Cameron T.; Watson, Jeffry T.

doi:10.1016/j.jhsa.2012.04.007

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…If the athlete has a partial LT injury, arthroscopic debridement may be considered, with or without electrothermal treatment. Reported outcomes are overall encouraging, with good to excellent pain relief in 20-100% and post-operative grip strength of 67-97% compared to the non-injured side [42,43]. When the athlete has a complete LT ligament tear, acute repair or reconstruction, with or without capsulodesis, may be performed.…”

Section: Treatment Of Lt Injuriesmentioning

confidence: 97%

“…Similar to SL injuries, the Geissler grading system is utilized for classification [9]. Recent review articles highlight the limited amount of research available [11,42,43]. In general, LT injuries are treated non-operatively with immobilization for 4-6 weeks and may be supplemented with intra-articular steroid injections or NSAIDS [42].…”

Section: Treatment Of Lt Injuriesmentioning

confidence: 99%

“…Arthrodesis of the LT joint is another procedure advocated to treat patients with resistant LT instability because patients with congenital LT coalition generally have normal grip strength and ROM [11,42]. LT fusion has been found to have a range of motion 59-85% of normal, grip strength 59-93% of normal, and patient-reported satisfaction 0 to 93% with 27 to 59% of patients still reporting pain [11,42,43].…”

Section: Treatment Of Lt Injuriesmentioning

confidence: 99%

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Scapholunate and perilunate injuries in the athlete

Morrell

Moyer

Quinlan

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of the review Scapholunate and perilunate injuries can be difficult to diagnose and treat in the athlete. In this review article, we present the mechanism of injury, evaluation, management, and outcomes of treatment for these injuries. Recent findings Acute repair of dynamic scapholunate ligament injuries remains the gold standard, but judicious use of a wrist splint can be considered for the elite athlete who is in season. The treatment of static scapholunate ligament injury remains controversial. Newer SL reconstructive techniques that aim to restore scapholunate function without compromising wrist mobility as much as tenodesis procedures show promise in athlete patients. Summary Acute injuries to the scapholunate ligament are best treated aggressively in order to prevent the sequelae of wrist arthritis associated with long-standing ligamentous injury. Acute repair is favored. Reconstructive surgical procedures to manage chronic scapholunate injury remain inferior to acute repair. The treatment of lunotriquetral ligament injuries is not well defined.

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Section: Treatment Of Lt Injuriesmentioning

confidence: 97%

Section: Treatment Of Lt Injuriesmentioning

confidence: 99%

Section: Treatment Of Lt Injuriesmentioning

confidence: 99%

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Scapholunate and perilunate injuries in the athlete

Morrell

Moyer

Quinlan

et al. 2017

Curr Rev Musculoskelet Med

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“…We recommend 6 weeks of wrist and forearm cast immobilization, followed by observation before operation. 6 A typical patient with LT ligament injury has a history of trauma or repeated stress. Ulnar wrist pain is persistent and worsens with activities.…”

mentioning

confidence: 99%

Arthroscopic Thermal Shrinkage of Lunotriquetral Ligament Incomplete Tear without Triangular Fibrocartilage Complex Perforation

Kim,

Hwang,

Kim

et al. 2024

J Wrist Surg

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Background Few studies have reported the clinical results of arthroscopic debridement and thermal shrinkage for partial lunotriquetral (LT) ligament injury. Purpose We estimated the outcomes of arthroscopic thermal shrinkage of a traumatic LT ligament incomplete tear without triangular fibrocartilage complex (TFCC) perforation. Methods We evaluated the results of 24 patients. The mean follow-up was 16 months. Radiographs were examined for ulnar variance (UV) and radioulnar distance on a true lateral radiograph, and wrist function was assessed based on grip strength, Mayo wrist score, and Disabilities of the Arm, Shoulder, and Hand (DASH) score, both pre- and postoperatively. Results On preoperative magnetic resonance imaging (MRI), no obvious LT ligament tear was observed in any of the patients. The preoperative LT shear test was positive in 19 cases, while the LT ballottement test was positive in 18 cases and the ulnar stress test in 16 cases. Preoperatively, the average radiographic UV was 2.1 mm and the average radioulnar distance was 0.9 mm. The LT tear type was a flap tear in 22 cases and bucket handle tear in 2 cases arthroscopically. The visual analog pain scale score improved postoperatively (from 7.5 to 0.4). The average grip strength improved from 72.7% preoperatively to 89.8% postoperatively. The Mayo wrist score was excellent/good in 6/15 cases and fair in 3 cases, with the scores ranging from 68 to 87. The average DASH score improved from 36.8 to 7. Conclusion We should be careful to differentiate LT ligament tears from TFCC lesions in the cases with ulnar wrist pain, because LT ligament tears may not be detected by MRI. Arthroscopic thermal shrinkage for traumatic LT ligament tear can be an effective treatment. Level of Evidence Level IV.

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“…2 However, consensus on treatment of chronic injuries is far less clear. 3,7,8 Treatment of chronic injuries focuses on restoring the premorbid equilibrium of the carpus. Treatment strategies can be broadly divided into two main groups: ligament reconstruction and arthrodesis.…”

mentioning

confidence: 99%

Revisiting Lunotriquetral Arthrodesis in Chronic Lunotriquetral Ligamentous Injuries

2022

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Background Chronic lunotriquetral (LT) ligament tears are a source of ulnar-sided wrist pain. Left untreated, complete tears of the LT ligament may progress to a volar intercalated segment instability deformity and eventual carpal arthritis. Various treatments have been proposed, one of which is LT arthrodesis. LT arthrodesis has been criticized for high rates of nonunion frequently requiring reoperation, and therefore has largely fallen out of favor. However, our experience has been quite different from the literature. This study examines a single surgeon's experience with LT arthrodesis over a 15-year period. Methods A retrospective review of the senior author's practice over a 15-year period was performed. All adult cases of LT arthrodesis for chronic LT injuries were included. Headless compression screw and cancellous bone graft from the distal radius were used for primary arthrodesis in all cases. The primary outcome was rate of union, and secondary outcomes were time to union, secondary or salvage procedures, and range of motion. Nonparametric statistical analysis was used to calculate differences in outcomes. Results Twenty-eight patients met inclusion criteria. The median age was 45.5 (interquartile range [IQR] 35–50) years and 75% were male. The dominant hand was most commonly affected. Eighty-six percent of patients achieved union, one patient required redo arthrodesis, and one patient went on to wrist salvage. Three patients developed a pain-free pseudoarthrosis. Median time to radiographic union was 8.8 (IQR 5.9–11.9) weeks. Conclusion Despite multiple previous reports, this study demonstrates that LT arthrodesis for chronic LT injuries is a safe technique with high rates of successful union. Further comparative studies are warranted to determine the optimal treatment for chronic LT injuries.

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Lunotriquetral Ligament Tears

Cited by 10 publications

References 17 publications

Scapholunate and perilunate injuries in the athlete

Scapholunate and perilunate injuries in the athlete

Arthroscopic Thermal Shrinkage of Lunotriquetral Ligament Incomplete Tear without Triangular Fibrocartilage Complex Perforation

Revisiting Lunotriquetral Arthrodesis in Chronic Lunotriquetral Ligamentous Injuries

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