Arthroscopical reconstruction of the volar and dorsal part of the scapholunate ligament as treatment for complete scapholunate ligament injury, but reducible carpal malalignment. This prospective study aims to evaluate the clinical and functional outcome of this technique on the short and middle term
Classical arthroscopic techniques for scapholunate instability consist of debridement, thermal shrinkage, and percutaneous pinning. Good results are obtained in acute lesions or in chronic partial tears, but they are less predictable when the lesion is complete, because of the poor healing capacity of the scapholunate ligament and because it is not possible to perform an anatomic ligamentous reconstruction with these techniques. Open techniques are thus required for reconstruction, but they damage the soft tissues. Corella et al. published a description and cadaver study of an arthroscopic ligamentoplasty, trying to combine the advantages of arthroscopic techniques (minimally invasive surgery) and open techniques (reconstruction of the ligament). With this approach, it is possible to reconstruct the dorsal scapholunate ligament and the secondary stabilizers while causing minimal damage to the soft tissues and avoiding injury to the posterior interosseous nerve and detachment of the dorsal intercarpal ligament. Arthroscopic scapholunate volar and dorsal ligament reconstruction achieves an anatomic reconstruction to provide a strong construct for early mobilization.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
reconstruction of the SL ligament with palmaris tendon graft tunneled through the scaphoid and lunate as described by Corella et al.
Department of orthopaedics RZ Tienen
Tienen, Belgium
passive and active range of motion (degrees) operated and contralateral side
flexion, extension, ulnar and radial deviation
Time frame: preop
passive and active range of motion (degrees) operated and contralateral side
flexion, extension, ulnar and radial deviation
Time frame: postoperative 3 months
passive and active range of motion (degrees) operated and contralateral side
flexion, extension, ulnar and radial deviation
Time frame: postoperative 6 months
passive and active range of motion (degrees) operated and contralateral side
flexion, extension, ulnar and radial deviation
Time frame: postoperative 12 months
grip strength (kg) operated and contralateral side
dynamometer (kg)
Time frame: preop
grip strength (kg) operated and contralateral side
dynamometer (kg)
Time frame: postoperative 3 months
grip strength (kg) operated and contralateral side
dynamometer (kg)
Time frame: postoperative 6 months
grip strength (kg) operated and contralateral side
dynamometer (kg)
Time frame: postoperative 12 months
pain (visual analogue scale)
Visual analogue Scale (0 no pain -10 cm worst pain)
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Time frame: preop
pain (visual analogue scale)
Visual analogue Scale Scale (0 no pain -10 cm worst pain)
Time frame: postoperative 3 months
pain (visual analogue scale)
Visual analogue Scale Scale (0 no pain -10 cm worst pain)
Time frame: postoperative 6 months
pain (visual analogue scale)
Visual analogue Scale (0 no pain -10 cm worst pain)
Time frame: postoperative 12 months
Disabilities of the Arm, Shoulder and Hand score
function score (0 is best -100 is worst)
Time frame: preop
Disabilities of the Arm, Shoulder and Hand score
function score (0 is best -100 is worst)
Time frame: postoperative 3 months
Disabilities of the Arm, Shoulder and Hand score
function score (0 is best -100 is worst)
Time frame: postoperative 6 months
Disabilities of the Arm, Shoulder and Hand score
function score (0 is best -100 is worst)
Time frame: postoperative 12 months
patient satisfaction after treatment
visual analogue scale (0 is worst -10 cm is best)
Time frame: postoperative 12 months
complications
descriptive
Time frame: postoperative 12 months
arthroscopical assessment of the scapholunate stability
according to European Wrist Arthroscopy Society classification (EWAS1 best -5 worst)
Time frame: intraoperative
scapholunate distance, carpal angles
radiological follow-up (distance in mm or angles in degrees)
Time frame: preop
scapholunate distance, carpal angles
radiological follow-up (distance in mm or angles in degrees)
Time frame: postoperative 12 months