Treatment of scapholunate dissociation by ligamentous repair and capsulodesis

Lavernia, Carlos J.; Cohen, Mark S.; Taleisnik, Julio

doi:10.1016/0363-5023(92)90419-p

Cited by 240 publications

(129 citation statements)

References 26 publications

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“…A direct open repair should be considered and the repair protected with K-wires as described above. Concomitant dorsal capsulodesis has shown to be useful in reinforcing the repair [8]. However, in our experience, it has a significant drawback by restricting palmar flexion.…”

Section: Grade III and Grade Iv Injuriesmentioning

confidence: 82%

Arthroscopic Management of Scapholunate Dissociation

Lindau

2010

Arthroscopic Management of Distal Radius Fractures

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Section: Grade III and Grade Iv Injuriesmentioning

confidence: 82%

Arthroscopic Management of Scapholunate Dissociation

Lindau

2010

Arthroscopic Management of Distal Radius Fractures

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“…Unlike other techniques, ARASL improves symptoms while preserving ROM. ARASL is associated with a 20% loss ROM, whereas other techniques result in a loss of ROM ranging from 10% to 45% (capsulodesis 10%-45% [6,16], tenodesis 31% [7,10,12], bone-tendon-bone reconstruction 40% [13,29], dynamic tendon transfer 46% [22]). In addition, grip strength was adequate after surgery (78% of the contralateral wrist).…”

Section: Discussionmentioning

confidence: 99%

“…for the introduction of several surgical techniques (ie, partial carpal fusions [19,21,24,26,27,30,31], capsulodesis [6,16], tenodesis [7,10,12], bone-tendon-bone reconstructions [13,29], and dynamic tendon transfers [13,29]). Most reflect an aggressive approach and do not lead to an ideal or sustained SL joint alignment [1,[26][27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

“…Most reflect an aggressive approach and do not lead to an ideal or sustained SL joint alignment [1,[26][27][28][29][30]. Although most of these techniques have been associated major improvement in pain and grip strength [6,16] none has restored or preserved SL joint alignment [13,23]. Moreover, these procedures result in substantial deterioration of wrist motion (10%-40%) and grip strength (13%-35%).…”

Section: Introductionmentioning

confidence: 99%

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Arthroscopic Scapholunate Joint Reduction. Is an Effective Treatment for Irreparable Scapholunate Ligament Tears?

Caloia

Pereira

2012

Clinical Orthopaedics &Amp; Related Research

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Background Irreparable tears to the scapholunate (SL) interosseous ligament area are common causes of mechanical wrist pain and yet treatment of this condition remains challenging. The reduction association of the SL joint (RASL) technique alleviates pain while preserving wrist function by creating a fibrous pseudarthrosis stabilized by a cannulated screw placed through the SL joint. Although arthroscopic RASL (ARASL) is a minimally invasive alternative to the open procedure, its effectiveness in controlling pain and preserving wrist function has not been established. Questions/purposes To determinate whether ARASL was obtained relieve pain and restore function to the wrist. Patients and MethodsWe reviewed eight patients (nine wrists) who had ARASL for SL instability with a reducible SL ligament tear (chronic lesion) from 2005 to 2009. Seven of eight were males and mean age was 44.5 years (range, 38-56 years). We recorded pain using a scale, the Disabilities of the Arm, Shoulder and Hand (DASH) score, grip strength, and range of motion (ROM). Minimum followup was 12 months (mean, 34.6 months; range, 12-43 months). Results The visual analog pain score was rated 5.4 (range, 0-10) preoperatively and 1.5 (1-3) after ARASL. Postoperative grip strength of the wrist was 78% of the contralateral, unaffected wrist. The average postoperative wrist ROM was to 107°, 20% less than the preoperative ROM. The SL angle decreased from 70.5°to 59.3°. In three cases, screws were removed owing to loosening or symptoms. Conclusions Our preliminary observations suggest ARASL for treating irreparable SL ligament tear is feasible, controls pain, and improves wrist function while preserving ROM. Larger series with longer followup are required to confirm our observations.

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“…Additionally, a capsulodesis should be performed using the technique described below. With this technique, Lavernia et al (20) found significant pain relief, improved grip strength and X-ray appearance, with only a slight change in range of motion (ROM) due to a loss of palmar flexion, which averaged 11.5 degrees.…”

Section: Subacute Injuriesmentioning

confidence: 99%

Wrist: Current Diagnosis and Treatment of Scaphoid Fractures and Injuries of the Scapholunate Ligament

Krimmer

2003

Eur Surg

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Summary: Background: Fractures of the scaphoid and injuries to the scapholunate ligament are mostly seen as causes of the acute and chronic painful wrist. Strict guidelines are necessary to precisely detect these lesions in the acute stage and to provide adequate treatment. A computed tomography bone scan parallel to the long axis of the scaphoid is best for demonstrating fractures and any associated deformities. Scapholunate ligament injuries are best staged by standard plane radiographs including stress views and by arthroscopy of the wrist. Methods: To avoid lengthy plaster immobilization and to lower the risk of nonunion, displaced and comminuted scaphoid fractures of the wrist as well as all proximal pole fractures should be internally fixed. Headless screws such as the Herbert screw, now available in a cannulated shape, allow the minimally invasive stabilization of the majority of these fractures with a high success rate under early mobilization. Undisplaced fractures can be treated conservatively with a below-elbow cast; alternatively, they can be stabilized percutaneously without the need for immobilization in a cast. Early diagnosis of scapholunate ligament injuries is most important, as anatomical healing of the injured ligaments can be expected only with primary treatment including correct realignment of the scaphoid and lunate followed by immobilization in a cast for about 8 weeks. In cases of chronic lesions, ligament reconstruction or even partial wrist fusion can be performed. In order to assess the different procedures, precise classification and staging with regard to a dynamic or static pattern are needed. Results: Early rigid fixation of scaphoid fractures promotes a union rate of up to 100 % with rapid functional recovery. Primary repair of scapholunate ligament injuries provides the best clinical outcome. Ligament reconstruction or partial wrist fusion can help to prevent rapid secondary arthrotic changes in the wrist and leads to significant pain relief, albeit with restriction of mobility and grip strength. Conclusions: Standardized diagnosis and treatment of scaphoid fractures and scapholunate ligament injuries improve clinical outcome and significantly reduce post-traumatic arthrotic changes in the wrist.

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Treatment of scapholunate dissociation by ligamentous repair and capsulodesis

Cited by 240 publications

References 26 publications

Arthroscopic Management of Scapholunate Dissociation

Arthroscopic Management of Scapholunate Dissociation

Arthroscopic Scapholunate Joint Reduction. Is an Effective Treatment for Irreparable Scapholunate Ligament Tears?

Wrist: Current Diagnosis and Treatment of Scaphoid Fractures and Injuries of the Scapholunate Ligament

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