Radiological evaluation of scapholunate intercarpal ligamentoplasty for chronic scapholunate dissociation in cadavers

J Hand Surg Eur Vol. 2018 May;43(4):387-393. doi: 10.1177/1753193417746055. Epub 2017 Dec 4.

Abstract

We performed a cadaveric study to evaluate radiological performance of a technique for scapholunate intercarpal ligamentoplasty designed for treating reducible scapholunate dissociation. We created scapholunate instability in 12 fresh adult cadaveric forearms by sectioning the dorsal scapholunate interosseous ligament and the dorsal intercarpal ligament. All wrists showed scapholunate diastasis, dorsal intercalated segmental instability and posterior scaphoid subluxation. We performed scapholunate intercarpal ligamentoplasty in six wrists and Garcia-Elias three-ligament tenodesis in another six. Wrists were examined radiographically both after ligament sectioning and after ligamentoplasty to compare static and dynamic scapholunate gaps and scapholunate and capitolunate angles. Improvement was statistically significant in all measurements, reflecting a return to normal values. Posterior scaphoid subluxation was also corrected. There was no significant difference between the two treatment groups. Our findings suggest that ligamentoplasty can restore scapholunate joint stability and normal carpal anatomy.

Keywords: Wrist instability; ligamentoplasty; scapholunate dissociation; scapholunate ligament.

MeSH terms

  • Cadaver
  • Humans
  • Joint Instability / diagnostic imaging*
  • Joint Instability / physiopathology
  • Joint Instability / surgery*
  • Ligaments, Articular / diagnostic imaging*
  • Ligaments, Articular / surgery*
  • Lunate Bone / diagnostic imaging*
  • Lunate Bone / surgery
  • Scaphoid Bone / diagnostic imaging*
  • Scaphoid Bone / surgery