Outcomes of Dorsal Capsulodesis and Tenodesis for Treatment of Scapholunate Instability

Moran, Steven L.; Ford, Kerry S.; Wulf, Corey A.; Cooney, William P.

doi:10.1016/j.jhsa.2006.08.002

Cited by 133 publications

(99 citation statements)

References 24 publications

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“…The level of evidence for scapholunate ligament injuries is overall low, comprising a single comparative study [35] and largely retrospective series as well as some case reports. Ideally prospective, randomized controlled trials would answer questions about the efficacy of treatment methods, but the overall rarity of surgical intervention makes those studies unfeasible.…”

Section: Closing Remarksmentioning

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: Closing Remarksmentioning

confidence: 99%

Scapholunate Ligament Injuries: A Review of Current Concepts

Pappou

Basel

Deal

2013

Hand (New York, N,Y.)

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“…There are many described methods of ligament reconstruction, including tenodesis [28,29], free tendon graft [30], bone-retinaculum-bone (BRB) [31,32], reduction and association of the scaphoid and lunate ligament (RASL) [33,34], and the scapholunate axis method (SLAM) [35]. As with acute repair, dorsal capsulodesis may be performed in conjunction with any of these procedures [36].…”

Section: Operative Managementmentioning

confidence: 99%

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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“…[1][2][3][4] These injuries often result from highenergy trauma, including motor vehicle accidents, falls from a height, or contact sporting activities. Owing to the mechanism of injury, patients often present with significant trauma to other organ systems and extremities.…”

Section: Nature Of the Problemmentioning

confidence: 99%

“…13 The current consensus is that anatomic restoration of the carpus is difficult to achieve and maintain via nonoperative means. 3,6 Multiple studies have shown that the complex intercarpal relationships are maintained poorly by means of closed reduction and immobilization alone. 13,14 The "paradox of reduction" has been coined to describe this difficulty in closed reduction.…”

Section: Closed Reductionmentioning

confidence: 99%

“…Studies comparing perilunate injuries treated conservatively versus those that underwent open treatment have shown consistently better results in those patients that underwent operative fixation. 3,5,[10][11][12] Apergis and colleagues 14 used a scoring system based on pain, occupation, range of motion, and grip strength to compare the results of conservative versus surgical repair. The group treated with closed reduction had fair results in 3 and poor results in 5.…”

Section: Closed Reductionmentioning

confidence: 99%

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