scholarly journals Arthroscopically Assisted Ligamentoplasty for Axial and Dorsal Reconstruction of the Scapholunate Ligament

2016 ◽  
Vol 5 (2) ◽  
pp. e353-e359 ◽  
Author(s):  
Vicente Carratalá ◽  
Francisco J. Lucas ◽  
Eduardo Sánchez Alepuz ◽  
Eva Guisasola ◽  
Rafael Calero
Keyword(s):  
Scapholunate Ligament ◽  
Arthroscopically Assisted ◽  
Dorsal Reconstruction

scholarly journals Modern approaches to the treatment of scapholunate interosseous ligament injuries (literature review)

2020 ◽  
Vol 26 (4) ◽  
pp. 593-599
Author(s):  
O.G. Shershneva ◽  
◽  
I.V. Kirpichev ◽  
Keyword(s):  
Primary Repair ◽  
Clinical Manifestations ◽  
Tendon Graft ◽  
Open Approach ◽  
Scapholunate Ligament ◽  
Ligament Injuries ◽  
Chronic Instability ◽  
Interosseous Ligament ◽  
Acute Injuries ◽  
Arthroscopically Assisted

Introduction The scapholunate interosseous ligament binds the scaphoid and lunate together, and is the primary stabilising ligament between these two bones. Scapholunate injuries lead to chronic instability and degenerative arthritis of the wrist. Scapholunate injuries are graded based on the acuity and the severity of the injury. Purpose The paper is a review of various techniques used to repair or reconstruct the scapholunate ligament according to the clinical manifestations, anatomic and pathologic findings. Methods A review of the literature covering this topic is presented. Results Conservative treatment is primarily indicated in stable and partial ligament tears. Arthroscopic treatment is used when immobilization is unsuccessful. Arthroscopically assisted scapholunate reduction and K-wire fixation is commonly used for acute injuries. Primary repair of scapholunate injuries are performed in all tear types using an open approach. Surgical indications depend on the severity of the instability, time after trauma and the presence of degenerative changes. Acute repair of scapholunate ligament injuries remains the gold standard as an earlier intervention provides better results. Acute injuries to the scapholunate ligament require two-four weeks before surgery. Within this period the ligament is often still repairable itself both with or without supplementary capsulodesis procedures; ligament reconstruction is generally preferable in patients with chronic injures. There are many arthroscopic techniques to treat chronic scapholunate injures such as scapholunate ligament primary repair using various types of capsulodesis, tendon graft reconstruction, bone-ligament-bone procedure, various intercarpal fusions and proximal row carpectomy, total wrist fusion and arthroplasty. Conclusion Early diagnosis and management of scapholunate ligament tears are necessary to preserve wrist functions.

Arthroscopic Scapholunate Ligament Reconstruction, Volar and Dorsal Reconstruction

Hand Clinics ◽  
2017 ◽  
Vol 33 (4) ◽  
pp. 687-707 ◽  
Author(s):  
Fernando Corella ◽  
Miguel Del Cerro ◽  
Montserrat Ocampos ◽  
Clara Simon de Blas ◽  
Ricardo Larrainzar-Garijo
Keyword(s):  
Ligament Reconstruction ◽  
Scapholunate Ligament ◽  
Dorsal Reconstruction

The Use of Contact Biomechanics to Study the Intact, Proximal Row Carpectomy and Scaphoid Excision, Four Bone Fusion Wrist

2020 ◽  
Vol 16 (3) ◽  
pp. 189-193
Author(s):  
David H. Wei ◽  
Peter Tang
Keyword(s):  
Proximal Row Carpectomy ◽  
Scapholunate Ligament ◽  
Bone Fusion ◽  
Pressure Sensitive ◽  
Sensitive Film ◽  
Radiocarpal Joint ◽  
Pressure Sensitive Film ◽  
Number Of Authors

The study of contact biomechanics of the wrist is a challenge. This is partly due to the relatively small size of the joint as well as the lack of space in the radiocarpal joint which makes the delivery of investigative materials such as pressure sensitive film without causing artifact, difficult. Fortunately, a number of authors have studied the intact wrist, the scapholunate ligament injured wrist, the proximal row carpectomy and the scaphoid excision, four bone fusion. Despite some contrasting findings, there are some general concepts that we understand about wrist mechanics.

Factors Predicting the Outcome After Arthroscopically Assisted Stabilization of Acute High-Grade Acromioclavicular Joint Dislocations

2019 ◽  
Vol 47 (11) ◽  
pp. 2670-2677 ◽  
Author(s):  
Nina Maziak ◽  
Laurent Audige ◽  
Carmen Hann ◽  
Marvin Minkus ◽  
Markus Scheibel
Keyword(s):  
Clinical Outcome ◽  
Acromioclavicular Joint ◽  
High Grade ◽  
Radiological Outcome ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Outcome Parameters ◽  
Joint Dislocations ◽  
Anatomic Reduction ◽  
Arthroscopically Assisted

Background: Factors influencing the outcome after arthroscopically assisted stabilization of acute high-grade acromioclavicular (AC) joint dislocations remain poorly investigated. Purpose: To identify determinants of the radiological outcome and investigate associations between radiological and clinical outcome parameters. Study Design: Cohort study; Level of evidence, 3. Methods: The authors performed a retrospective analysis of patients who underwent arthroscopically assisted stabilization for acute high-grade AC joint dislocations. The following potential determinants of the radiological outcome were examined using univariable and multivariable regression analyses: timing of surgery, initial AC joint reduction, isolated coracoclavicular (CC) versus combined CC and AC stabilization, ossification of the CC ligaments, age, and overweight status. In addition, associations between radiological (ie, CC difference, dynamic posterior translation [DPT]) and clinical outcome parameters (Subjective Shoulder Value, Taft score [TS] subjective subcategory, and Acromioclavicular Joint Instability Score [ACJI] pain subitem) were evaluated using univariable analysis. Results: One hundred four patients with a mean (±SD) age of 38.1 ± 11.5 years were included in this study. The mean postoperative follow-up was 2.2 ± 0.9 years. Compared with patients with an overreduced AC joint after surgery, the CC difference was 4.3 mm (95% CI, 1.3-7.3; P = .006) higher in patients with incomplete reduction. Patients with anatomic reduction were 3.1 times (95% CI, 1.2-7.9; P = .017) more likely to develop DPT than those with an overreduced AC joint. An incompletely reduced AC joint was 5.3 times (95% CI, 2.1-13.4; P < .001) more likely to develop DPT versus an overreduced AC joint. Patients who underwent isolated CC stabilization were 4.8 times (95% CI, 1.1-21.0; P = .039) more likely to develop complete DPT than patients with additional AC stabilization. Significantly higher CC difference values were noted for patients who reported pain on the subjective TS ( P = .025). Pain was encountered more commonly in patients with DPT ( PTS = .049; PACJI = .038). Conclusion: Clinicians should consider overreduction of the AC joint because it may lead to favorable radiological results. Because of its association with superior radiographic outcomes, consideration should also be given to the use of additional AC cerclage.

scholarly journals Motion and Strength Analysis of 2-Tine Staple and K-Wire Fixation in Scapholunate Ligament Stabilization in a Cadaver Model

2021 ◽  
Vol 3 (2) ◽  
pp. 67-73
Author(s):  
Daniel Hess ◽  
Anthony Archual ◽  
Zachary Burnett ◽  
Hans Prakash ◽  
Emily Dooley ◽  
...  
Keyword(s):  
Strength Analysis ◽  
Scapholunate Ligament ◽  
Wire Fixation

Preliminary Report of Arthroscopically Assisted Sauvé–Kapandji Procedure for Distal Radioulnar Joint Arthritis

2021 ◽  
Author(s):  
Yukio Abe ◽  
Youhei Takahashi ◽  
Kenzo Fujii
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Kirschner Wire ◽  
Distal Radioulnar Joint ◽  
Contralateral Side ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Advantages And Disadvantages ◽  
Arthroscopically Assisted ◽  
Therapeutic Study

Abstract Background The arthroscopically assisted Sauvé–Kapandji (S-K) procedure has been described as a safe and promising technique for distal radioulnar joint (DRUJ) arthrodesis. Our purpose was to investigate the advantages and disadvantages of the arthroscopically assisted S-K procedure. Methods Eight patients underwent an arthroscopically assisted S-K procedure. All patients were diagnosed as DRUJ osteoarthritis (OA), including six primary DRUJ OA, one OA following a distal radius fracture, and one rheumatoid arthritis (RA). Arthroscopy was performed in neutral forearm rotation with vertical traction. The surface of the DRUJ was debrided through arthroscopy to expose the subchondral surface, and the DRUJ was fixed with a cannulated screw and Kirschner wire (K-wire) with zero or minus ulnar variance in the same posture. Bone graft was not performed. Results Bone union was achieved at 2 to 3.5 months postoperatively. At an average of 17-month follow-up, the pain intensity on 10-point numerical rating scale (NRS) decreased from 10 preoperatively to 0.4 postoperatively, average range of pronation significantly improved from 77 degrees to 89 degrees, and average grip strength as a percentage of contralateral side improved from 76 to 104%. Conclusion Satisfactory outcomes were achieved with the arthroscopically assisted S-K procedure. Advantages of this procedure included the ability to achieve union without bone grafting, preservation of the extensor mechanism integrity, and easy reduction of the ulnar head due to its wrist positioning. No major complications were encountered. Disadvantages included its required use of arthroscopic technique and potential contraindication for cases with severe deformity at the sigmoid notch. Level of Evidence This is a Level IV, therapeutic study.

scholarly journals Kinematic analysis of two scapholunate ligament reconstruction techniques

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110258
Author(s):  
Seungbum Chae ◽  
Junho Nam ◽  
Il-Jung Park ◽  
Steven S. Shin ◽  
Michelle H. McGarry ◽  
...  
Keyword(s):  
Kinematic Analysis ◽  
Clinical Relevance ◽  
Ligament Reconstruction ◽  
Operative Time ◽  
Efficient Technique ◽  
Scapholunate Ligament ◽  
Interosseous Ligament ◽  
Flexion Extension

Purpose: This study compares the kinematic changes after the procedures for scapholunate interosseous ligament (SLIL) reconstruction—the modified Brunelli technique (MBT) and Mark Henry’s technique (MHT). Methods: Ten cadaveric wrists were used. The scapholunate (SL) interval and angle and radiolunate (RL) angle were recorded using the MicroScribe system. The SL interval was measured by dividing the volar and dorsal portions. Four motions of the wrist were performed—neutral, flexion, extension, and clenched fist (CF) positions—and compared among five conditions: (1) intact wrist, (2) volar SLIL resection, (3) whole SLIL resection, (4) MBT reconstruction, and (5) MHT reconstruction. Results: Under the whole SLIL resection condition, the dorsal SL intervals were widened in all positions. In all positions, the dorsal SL intervals were restored after MBT and MHT. The volar SL interval widened in the extension position after volar SLIL resection. The volar SL interval was not restored in the extension position after MBT and MHT. The SL angle increased in the neutral and CF positions under the whole SLIL resection condition. The SL angle was not restored in the neutral and CF positions after MBT and MHT. The RL angle increased in the neutral and CF positions under the whole SLIL resection condition. The RL angle was not restored in the neutral and CF positions after MBT and MHT. Conclusion: The MBT and MHT may restore the dorsal SL interval. No significant differences in restoration of the SL interval between MBT and MHT were found in the cadaveric models. Clinical relevance: No significant differences between MBT and MHT were found in the cadaveric models for SLIL reconstruction. When considering the complications due to volar incision and additional procedures in MHT, MBT may be a more efficient technique in terms of operative time and injury of the anterior structures during surgery, but further research is needed.

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