Scapholunate Interosseous Ligament Reconstruction: Results With a Modified Brunelli Technique Versus Four-Bone Weave

Links, Annie C.; Chin, Simon H.; Waitayawinyu, Thanapong; Trumble, Thomas E.

doi:10.1016/j.jhsa.2008.02.010

Cited by 54 publications

(31 citation statements)

References 23 publications

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“…Maintaining the distal part of the scaphoid in the axis of scapholunate complex by anchoring it, the free tendon graft will prevent rotatory subluxation of the scaphoid without the need of involvement of dorsal extrinsic ligaments as it is happening in modified Brunelli procedures. Since 1998, when Abbeele introduced his own modification to Brunelli procedure, we have found less than 400 cases treated with this technique [15,21-28]. The largest number of patients treated with this method were presented by Talwalker [25].…”

Section: Discussionmentioning

confidence: 99%

New concept of scapholunate dissociation treatment and novel modification of Brunelli procedure - anatomical study

Elsaftawy¹,

Jabłecki²,

Domanasiewicz³

et al. 2014

BMC Musculoskelet Disord

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BackgroundsThis paper describes a novel method in treatment of scapholunate dissociation accompanied with rotatory subluxation of the scaphoid. The idea of this method is to create a kind of axial lever that can fully reconstruct anatomical relationship between the scaphoid and the lunate, with no involvement of extrinsic ligaments, and with simultaneous restriction of pathological alignment of the scaphoid. Based on this technique, we have also proposed a new modification of Brunelli procedure in scapholunate dissociation with rotatory subluxation of the scaphoid and dorsal intercalated segmental instability.MethodsAt the initial stage of the study, 20 human wrists fixed in Ethanol were used, followed by 12 fresh human wrists used in part two. The first stage included functional, biomechanical and strength tests carried out by means of a 5 kg load and intended to find the most anatomical and durable treatment method. The second stage involved testing the proposed methods on fresh cadaver wrists.ResultsWe have discovered that the new method is able to recreate anatomical forces and properties of scapholunate ligament; what’s more, it can also prevent rotatory subluxation of the scaphoid. The performed strength tests have proven that it is possible to treat scapholunate instability also in case of dorsal intercalated segmental instability.ConclusionsWe highly recommend using both the new technique and the new modification of Brunelli procedure for treatment of scapholunate dissociation in both dynamic and static instabilities.

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Section: Discussionmentioning

confidence: 99%

New concept of scapholunate dissociation treatment and novel modification of Brunelli procedure - anatomical study

Elsaftawy¹,

Jabłecki²,

Domanasiewicz³

et al. 2014

BMC Musculoskelet Disord

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show abstract

“…Links 44 retrospectively compared 2 groups of patients with chronic SL dissociation. One group received an MBT with RASL (Fig.…”

Section: Ligament Reconstructionmentioning

confidence: 99%

Scapholunate Ligament Tears

Ward

Fowler

2015

Orthopedic Clinics of North America

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“…20 As an alternative to capsulodesis and in cases with insufficient scapholunate ligament tissue for repair, a tendon graft can be used to stabilize the scaphoid at both ends. 18,[21][22][23][24][25] The modified Brunelli procedure involves transfer of a distally based strip of flexor carpi radialis tendon through the scaphoid and across the scapholunate interval. At short-and mid-term followup, the procedure has shown similar outcomes when compared to a dorsal capsulodesis procedure, 18 and better results when compared to a 4-bone tendon weave surgery.…”

Section: Reducible Scapholunate Jointmentioning

confidence: 99%

“…At short-and mid-term followup, the procedure has shown similar outcomes when compared to a dorsal capsulodesis procedure, 18 and better results when compared to a 4-bone tendon weave surgery. 24 Improved wrist pain and approximately 25% loss of wrist motion are reported. Recurrence of a scapholunate gap is less common than that after dorsal capsulodesis procedures [11][12][13][17][18][19][20]24,25 ; however, the potential for progressive arthritis is not eliminated by this operation, with SLAC changes noted in 5% to 24% of cases at a mean follow-up of 3 to 4 years.…”

Section: Reducible Scapholunate Jointmentioning

confidence: 99%

“…24 Improved wrist pain and approximately 25% loss of wrist motion are reported. Recurrence of a scapholunate gap is less common than that after dorsal capsulodesis procedures [11][12][13][17][18][19][20]24,25 ; however, the potential for progressive arthritis is not eliminated by this operation, with SLAC changes noted in 5% to 24% of cases at a mean follow-up of 3 to 4 years. 18,21,25 Less commonly reported procedures include re-approximation of the scaphoid and lunate with temporary or permanent screw fixation, 26 dynamic tendon transfer, [27][28][29] and scapholunate interval reconstruction using a bone-soft tissue-bone graft.…”

Section: Reducible Scapholunate Jointmentioning

confidence: 99%

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