Scaphometacarpal Stabilization Technique for Repairable Scapholunate Injury

Abstract

Despite the numerous techniques (both arthroscopic and open) for the treatment of acute scapholunate instability, there is no consensus on which one results in better healing of the ligaments. In the present work, we describe a new surgical technique to achieve stability of the scaphoid that enables the reduction inflexion and pronation of this bone when dissociation is produced. Using a high-strength suture wire with double cortical button anchor (Mini TightRope, Arthrex, Naples, FL, US, or MicroLink, Conmed, Largo, FL, US) stabilization of the scaphoid is achieved to protect ligament healing without the need for postoperative immobilization.

Resumen

A pesar de las numerosas técnicas (tanto artroscópicas como abiertas) para el tratamiento de la inestabilidad escafolunar aguda, no existe un consenso sobre cuál produce una mejor cicatrización ligamentosa. En este trabajo, presentamos una nueva técnica quirúrgica para conseguir una estabilización escafoidea que permita disminuir la flexión y la pronación del escafoides cuando se produce la disociación. Mediante un cable de sutura de alta resistencia con doble anclaje tipo botón cortical (Mini TightRope, Arthrex, Naples, FL, EEUU, o MicroLink, Conmed, Largo, FL, EEUU), se consigue una estabilización dinámica del escafoides para proteger la cicatrización ligamentosa sin necesidad de inmovilización postoperatoria.

Keywords

scapholunate lesion - dynamic stabilization - mobilization - recovery

Publikationsverlauf

Eingereicht: 12. Juli 2021

Angenommen: 18. November 2021

Artikel online veröffentlicht:
23. Juni 2022

• References

• 1 Rajan PV, Day CS. Scapholunate Interosseous Ligament Anatomy and Biomechanics. J Hand Surg Am 2015; 40 (08) 1692-1702 DOI: 10.1016/j.jhsa.2015.03.032.
• 2 Geissler WB. Arthroscopic management of scapholunate instability. J Wrist Surg 2013; 2 (02) 129-135 DOI: 10.1055/s-0033-1343354.
• 3 Mathoulin C. Treatment of dynamic scapholunate instability dissociation: Contribution of arthroscopy. Hand Surg Rehabil 2016; 35 (06) 377-392 DOI: 10.1016/j.hansur.2016.09.002.
• 4 Corella F, Del Cerro M, Ocampos M, Larrainzar-Garijo R. Arthroscopic ligamentoplasty of the dorsal and volar portions of the scapholunate ligament. J Hand Surg Am 2013; 38 (12) 2466-2477 DOI: 10.1016/j.jhsa.2013.09.021.
• 5 Carratalá V, Lucas FJ, Miranda I, Prada A, Guisasola E, Miranda FJ. Arthroscopic Reinsertion of Acute Injuries of the Scapholunate Ligament Technique and Results. J Wrist Surg 2020; 9 (04) 328-337 DOI: 10.1055/s-0040-1710502.
• 6 Park I-J, Maniglio M, Shin SS, Lim D, McGarry MH, Lee TQ. Internal Bracing Augmentation for Scapholunate Interosseous Ligament Repair: A Cadaveric Biomechanical Study. J Hand Surg Am 2020; 45 (10) 985.e1-985.e9 DOI: 10.1016/j.jhsa.2020.03.017.
• 7 Luchetti R, Atzei A, Cozzolino R, Fairplay T. Current role of open reconstruction of the scapholunate ligament. J Wrist Surg 2013; 2 (02) 116-125 DOI: 10.1055/s-0033-1343092.
• 8 Kuo CE, Wolfe SW. Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am 2008; 33 (06) 998-1013 DOI: 10.1016/j.jhsa.2008.04.027.
• 9 Athlani L, Rouizi K, Granero J. et al. Assessment of scapholunate instability with dynamic computed tomography. J Hand Surg Eur Vol 2020; 45 (04) 375-382 DOI: 10.1177/1753193419893890.
• 10 Lee SK, Model Z, Desai H, Hsu P, Paksima N, Dhaliwal G. Association of lesions of the scapholunate interval with arthroscopic grading of scapholunate instability via the geissler classification. J Hand Surg Am 2015; 40 (06) 1083-1087 DOI: 10.1016/j.jhsa.2015.02.017.