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DOI: 10.1055/s-0042-1758189
Extensor Carpi Radialis Longus Ligamentoplasty as a Reconstruction Technique for Scapholunate Injuries
Artikel in mehreren Sprachen: español | English
Abstract
Objective To describe the arthroscopic surgical technique for the reconstruction of the scapholunate ligament using the extensor carpi radialis longus (ECRL) as a donor. This muscle can be very useful in this kind of procedure due to its biomechanical properties.
Surgical Technique After an initial diagnostic arthroscopy of the wrist, ligamentous reconstruction was carried out using an ECRL hemitendon though a minimally-invasive technique. The fixation devices used were the SwiveLock for the scaphoid and a 3 × 8-mm biotenodesis screw (Arthrex, Naples, FL, US) for the lunate.
Complications Difficult extraction of the ECRL tendon is the most frequent complication, due to an anatomical intersection between the first and second extensor compartments. It can be easily solved by performing an intermediate incision at this level to ensure the adequate release of the plasty.
Conclusion It is possible to perform a reconstruction of the scapholunate ligament using the ECRL hemitendon. Due to its biomechanical properties, it may be more advantageous to restore the carpal biomechanics. Further studies are required to confirm the suitability and superiority of this donor compared to others in reconstruction techniques.
Publikationsverlauf
Eingereicht: 03. März 2022
Angenommen: 19. Juli 2022
Artikel online veröffentlicht:
16. Dezember 2022
© 2022. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
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Referencias
- 1 Mullikin I, Srinivasan RC, Bagg M. Current techniques in scapholunate ligament reconstruction. Orthop Clin North Am 2020; 51 (01) 77-86
- 2 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
- 3 García-Elías M, Puig de la Bellacasa I, Schouten C. Carpal ligaments. A functional classification. Hand Clin 2017; 33 (03) 511-520
- 4 Esplugas M, García-Elias M, Lluch A, Llusá Pérez M. Role of muscles in the stabilization of ligament-deficient wrists. J Hand Ther 2016; 29 (02) 166-174
- 5 Hagert E. Proprioception of the wrist joint: a review of current concepts and possible implications on the rehabilitation of the wrist. J Hand Ther 2010; 23 (01) 2-17
- 6 Salvá-Coll G, García-Elías M, Hagert E. Scapholunate instability: proprioception and neuromuscular control. J Wrist Surg 2013; 2 (02) 136-140
- 7 Hagert E, Lluch A, Rein S. The role of proprioception and neuromuscular stability in carpal instabilities. J Hand Surg Eur Vol 2016; 41 (01) 94-101
- 8 Salvà-Coll G, García-Elías M, Llusá-Pérez M, Rodríguez-Baeza A. The role of the flexor carpi radialis muscle in scapholunate instability. J Hand Surg Am 2011; 36 (01) 31-36
- 9 Short WH, Werner FW, Green JK, Masaoka S. Biomechanical evaluation of ligamentous stabilizers of the scaphoid and lunate. J Hand Surg Am 2002; 27 (06) 991-1002
- 10 Short WH, Werner FW, Green JK, Masaoka S. Biomechanical evaluation of the ligamentous stabilizers of the scaphoid and lunate: Part II. J Hand Surg Am 2005; 30 (01) 24-34
- 11 Short WH, Werner FW, Green JK, Sutton LG, Brutus JP. Biomechanical evaluation of the ligamentous stabilizers of the scaphoid and lunate: part III. J Hand Surg Am 2007; 32 (03) 297-309
- 12 Linscheid RL, Dobyns JH. Treatment of scapholunate dissociation. Rotatory subluxation of the scaphoid. Hand Clin 1992; 8 (04) 645-652
- 13 Kakar S, Greene RM, García-Elías M. Carpal realignment using a strip of extensor carpi radialis longus tendon. J Hand Surg Am 2017; 42 (08) 667.e1-667.e8
- 14 Almquist EE, Bach AW, Sack JT, Fuhs SE, Newman DM. Four-bone ligament reconstruction for treatment of chronic complete scapholunate separation. J Hand Surg Am 1991; 16 (02) 322-327
- 15 Corella F, Del Cerro M, Ocampos M, Simon de Blas C, Larraínzar Garijo R. Arthroscopic scapholunate volar and dorsal reconstruction. Hand Clin 2017; 33 (04) 687-707
- 16 Corella F, Ocampos M, Cerro MD, Larraínzar-Garijo R, Vázquez T. Volar Central Portal in wrist arthroscopy. J Wrist Surg 2016; 5 (01) 80-90