Treatment of static scapholunate dissociation using a slip of the flexor carpi radialis

Zafra, Manuel; Uceda, Pilar

doi:10.1007/s00590-020-02706-2

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…SL dissociation is the most common form of carpal instability and can be treated with various repair or stabilization procedures [ 12 – 14 ]. Radiographs to identify the SL gap are important in the diagnosis and treatment of SL dissociation and standard PA radiographs may not accurately show this SL gap due to overlap between the scaphoid and lunate articular surfaces.…”

Section: Discussionmentioning

confidence: 99%

The tangential view described by Moneim to demonstrate scapholunate dissociation: an update

Imada

Welch

Mlady

et al. 2022

Eur J Orthop Surg Traumatol

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Purpose Scapholunate dissociation is a common and significant injury to the wrist. Radiographs are important in the diagnosis of this injury and in the planning of treatment. The tangential radiograph view was described almost 40 years ago as a method for accurately measuring scapholunate gaps. The hand is positioned on a 20° foam rubber block and the thumb on the cassette, which positions the scaphoid and lunate articular surfaces parallel, without patient discomfort or effort. The goal of this study was to review this method with more recent data and in a larger group of patients. Methods Radiographs of 31 patients who had scapholunate interosseous ligament tears and surgical repair over a 9 year period were retrospectively evaluated. Each of the four authors independently measured scapholunate gaps for posteroanterior and tangential views. Results The tangential view gaps were significantly greater than the posteroanterior gaps overall. Similar results were found for borderline cases where the posteroanterior gap was less than 3 mm. Every tangential view gap measurement was greater than its respective posteroanterior gap with good inter-rater reliability. Conclusion The tangential view is a reliable radiographic method to identify scapholunate gaps. It should be obtained when there is clinical concern for scapholunate dissociation, especially in patients with borderline posteroanterior gaps.

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Section: Discussionmentioning

confidence: 99%

The tangential view described by Moneim to demonstrate scapholunate dissociation: an update

Imada

Welch

Mlady

et al. 2022

Eur J Orthop Surg Traumatol

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Comparison of Outcomes of Scapholunate Ligament Reconstruction Techniques

Ilyas

2022

J Wrist Surg

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Introduction Injury to the scapholunate interosseous ligament (SLIL) is a common cause of carpal instability, yet surgical management of chronic SLIL disruption remains challenging with no optimal technique identified. Purpose The purpose of this meta-analysis was to comparatively review the available evidence of clinical, radiographic, and patient-reported outcome measures among popular techniques of SLIL reconstruction (capsulodesis, tenodesis, and bone-tissue-bone graft) to better guide management of SLIL injuries. Methods A total of 1,172 patients from 42 included studies were assessed. Standardized data extraction and analysis were performed. The mean of postoperative outcome assessments with standard deviation was used to calculate pooled standardized mean difference with 95% confidence interval. Results Visual Analog Scale (VAS) score for postoperative pain was lowest in bone-tissue-bone patients at 0.9 (p = 0.0360). Bone-tissue-bone patients had the highest percentage of “excellent” functional outcomes at 64.5% (p < 0.0001). Disabilities of the Arm, Shoulder, and Hand (DASH)/QuickDASH score was best in bone-tissue-bone patients at 9.7 (p < 0.0001). Patient-Rated Wrist Evaluation (PRWE) score was best in tenodesis patients at 37.8 (p = 0.0255). There were no statistically significant differences in grip strength, range of motion, or radiographic outcomes among the techniques. Conclusion Existing data demonstrate some benefit of bone-tissue-bone reconstruction over capsulodesis and tenodesis in pain reduction and functional improvement of the injured wrist. No statistically significant differences among radiographic outcomes could be ascertained, possibly attributable to the heterogeneity of procedures. This review provides an updated reference and highlights the need for multicenter trials with longer term follow-up and more standardized outcome measures.

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A Scaphoid Safety Scapholunate Interosseous Ligament Reconstruction. The Non–Bone Tunnel Technique and Clinical Outcomes

Tuntiyatorn,

Rojpitipongsakorn,

Chulsomlee

et al. 2024

Techniques in Orthopaedics

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Objective: In the chronic unrepairable scapholunate interosseous ligament (SLIL) injury stage, scapholunate ligament (SL) reconstruction remains the gold standard treatment. However, most surgical techniques are required to make the bone tunnel by drilling through the scaphoid, which may introduce iatrogenic scaphoid fracture as a complication. Thus, the aim of this study was to describe an alternative surgical technique for SLIL reconstruction by using a double anchor suture instead of bone drilling. Materials and Methods: A total of 5 consecutive cases of chronic scapholunate dissociation that underwent the non–bone tunnel technique of SLIL reconstruction were included in the study. The clinical data between the preoperative and postoperative were collected. Results: In 5 cases, a ligament reconstruction was achieved successfully. At 12 weeks after the surgery. The average Visual Analog Scale improved from 8.4 to 1.0. The clinical stress test was negative without pain. The mean grip strength improved to 85.4% compared with the normal contralateral hand. The mean Quick Disabilities of the Arm, Shoulder, and Hand score was 8.62 compared with the preoperative score of 70.92. Mean of SL interval in wrist with anteroposterior view and anteroposterior clenched fist view at 2.50 mm and 2.68 mm. Conclusion: The scaphoid safety SLIL reconstruction technique is a simple and reliable treatment method, using flexor carpi radialis tendon weave and anchor-ligament-anchor procedure instead of previous bone tunnel techniques. Biomechanical strength of the system demonstrated by postoperative results of scaphoid flexion was corrected, but SL gaps were still remaining in some cases. However, there was no effect on clinical outcomes and patient satisfaction.

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Treatment of static scapholunate dissociation using a slip of the flexor carpi radialis

Cited by 3 publications

References 26 publications

The tangential view described by Moneim to demonstrate scapholunate dissociation: an update

The tangential view described by Moneim to demonstrate scapholunate dissociation: an update

Comparison of Outcomes of Scapholunate Ligament Reconstruction Techniques

A Scaphoid Safety Scapholunate Interosseous Ligament Reconstruction. The Non–Bone Tunnel Technique and Clinical Outcomes

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