Outcomes of scapholunate intercarpal ligamentoplasty for chronic scapholunate dissociation: a prospective study in 26 patients

J Hand Surg Eur Vol. 2018 Sep;43(7):700-707. doi: 10.1177/1753193418772801. Epub 2018 May 10.

Abstract

We report the outcomes of scapholunate intercarpal ligamentoplasty in 26 wrists. For 15 wrists with static instability and 11 with dynamic instability, we used a free palmaris longus graft to reconstruct the dorsal part of the scapholunate interosseous ligament and the dorsal intercarpal ligament. These patients were evaluated for pain and active wrist range of motion, grip strength and radiological appearance after a mean follow-up of 36 months (range 12-54) after surgery. Pain score was improved from 4.5 to 1.4 at rest and 6.7 to 1.9 during hand use. The average wrist flexion was 57°, extension 56°. Grip strength was 89% of the contralateral side. The mean scapholunate angle decreased from 76° to 62°, and static scapholunate gap reduced from 3.2 mm to 2.3 mm and the dynamic gap from 4.6 mm to 3.0 mm. Scaphoid subluxation was corrected. We conclude that this procedure led to satisfactory clinical and radiological results in a short- to mid-term follow-up.

Level of evidence: II.

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

MeSH terms

  • Adult
  • Carpal Joints / diagnostic imaging
  • Carpal Joints / surgery*
  • Chronic Disease
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Hand Strength
  • Humans
  • Joint Instability / surgery*
  • Ligaments, Articular / diagnostic imaging
  • Ligaments, Articular / injuries
  • Ligaments, Articular / surgery*
  • Lunate Bone / diagnostic imaging
  • Lunate Bone / surgery*
  • Male
  • Middle Aged
  • Prospective Studies
  • Range of Motion, Articular
  • Scaphoid Bone / diagnostic imaging
  • Scaphoid Bone / surgery*
  • Tendons / transplantation*
  • Visual Analog Scale
  • Young Adult