Jnl Wrist Surg 2016; 05(01): 059-066
DOI: 10.1055/s-0035-1570744
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

ScaphoLunate Axis Method

Jeffrey Yao
1  Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, California
,
Dan A. Zlotolow
2  Department of Orthopaedic Surgery, Philadelphia Shriners Hospital, Temple School of Medicine, Philadelphia, Pennsylvania
,
Steve K. Lee
3  Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York
› Author Affiliations
Further Information

Publication History

01 June 2015

01 December 2015

Publication Date:
06 January 2016 (online)

Abstract

Background Treating chronic scapholunate ligament injuries without the presence of arthritis remains an unsolved clinical problem facing wrist surgeons. This article highlights a technique for reconstructing the scapholunate ligament using novel fixation, the ScaphoLunate Axis Method (SLAM).

Materials and Methods In a preliminary review of the early experience of this technique, 13 patients were evaluated following scapholunate ligament reconstruction utilizing the SLAM technique.

Description of Techinque The scapholunate interval is reconstructed utilizing a palmaris longus autograft passed between the scaphoid and lunate along the axis of rotation in the sagittal plane. It is secured in the lunate using a graft anchor and in the scaphoid utilizing an interference screw. The remaining graft is passed dorsally to reconstruct the dorsal scapholunate ligament.

Results At an average follow-up of 11 months, the mean postoperative scapholunate gap was 2.1 mm. The mean postoperative scapholunate angle was 59 degrees. The mean postoperative wrist flexion and extension was 45 and 56 degrees, respectively. The mean grip strength was 24.9 kg, or 62% of the contralateral side. The mean pain score (VAS) was 1.7. There was 1 failure with recurrence of the pathologic scapholunate gap and the onset of pain.

Conclusion While chronic scapholunate ligament instability remains an unsolved problem facing wrist surgeons, newer techniques are directed toward restoring the normal relationships of the scaphoid and lunate in both the coronal and sagittal planes. The SLAM technique has demonstrated promise in preliminary clinical studies.