TY - JOUR
T1 - Cable-augmented, quad ligament tenodesis scapholunate reconstruction
T2 - Rationale, surgical technique, and preliminary results
AU - Bain, Gregory I.
AU - Watts, Adam C.
AU - McLean, James
AU - Lee, Yu C.
AU - Eng, Kevin
PY - 2013/3/31
Y1 - 2013/3/31
N2 - Eight patients underwent scapholunate reconstruction using tensionable suture anchors. Adapted from a modified Brunelli technique, the anchors provide a fixed cable that reduces the scapholunate diastasis and maintains reduction during the healing phase. The flexor carpi radialis tendon graft is advanced through the scaphoid and stabilizes the volar scaphotrapezial ligament, dorsal scapholunate ligament, dorsal intercarpal ligament, and dorsal radiocarpal ligament. The ligament-sparing approach is closed using an ulnar advancement capsulodesis that further reinforces the dorsal intercarpal and dorsal radiocarpal ligament. Good clinical results were obtained. Measured on a visual analog scale (0 to 10), the average pain score improved from 5.8 to 2.1, average patient satisfaction was 7.6, average extension was 56 degrees (91% of contralateral side), flexion was 44 degrees (70% of contralateral side), and grip was strength 41 kg (95% of contralateral side). Radiographic parameters were less favorable. The average scapholunate angle was 71 degrees, radiolunate angle 16 degrees, and scapholunate interval 3.0 mm. The cable-augmented, quad ligament scapholunate ligament reconstruction offers theoretical advantages over previously published techniques, but long-term follow-up is required.
AB - Eight patients underwent scapholunate reconstruction using tensionable suture anchors. Adapted from a modified Brunelli technique, the anchors provide a fixed cable that reduces the scapholunate diastasis and maintains reduction during the healing phase. The flexor carpi radialis tendon graft is advanced through the scaphoid and stabilizes the volar scaphotrapezial ligament, dorsal scapholunate ligament, dorsal intercarpal ligament, and dorsal radiocarpal ligament. The ligament-sparing approach is closed using an ulnar advancement capsulodesis that further reinforces the dorsal intercarpal and dorsal radiocarpal ligament. Good clinical results were obtained. Measured on a visual analog scale (0 to 10), the average pain score improved from 5.8 to 2.1, average patient satisfaction was 7.6, average extension was 56 degrees (91% of contralateral side), flexion was 44 degrees (70% of contralateral side), and grip was strength 41 kg (95% of contralateral side). Radiographic parameters were less favorable. The average scapholunate angle was 71 degrees, radiolunate angle 16 degrees, and scapholunate interval 3.0 mm. The cable-augmented, quad ligament scapholunate ligament reconstruction offers theoretical advantages over previously published techniques, but long-term follow-up is required.
KW - carpal instability
KW - ligamentous reconstruction
KW - scapholunate dissociation
KW - tensionable anchors
KW - wrist instability
UR - http://www.scopus.com/inward/record.url?scp=84874611431&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874611431&partnerID=8YFLogxK
U2 - 10.1097/BTH.0b013e31827204ba
DO - 10.1097/BTH.0b013e31827204ba
M3 - Article (journal)
AN - SCOPUS:84874611431
SN - 1089-3393
VL - 17
SP - 13
EP - 19
JO - Techniques in Hand and Upper Extremity Surgery
JF - Techniques in Hand and Upper Extremity Surgery
IS - 1
ER -