Fig. 1
Schematic represenatation of the technique used
3 Results
Mean satisfaction was 7.5/10 (range 2–10), mean pain visual analog score was 2.7/10, and mean quick DASH score was 15.5 (range 5–33) with a maximum possible DASH of 55. All patients would have the same surgery again and only two patients had not returned to work because of the wrist. Range of motion was significantly reduced compared to the contralateral side as illustrated in Table 1 but was in all case within the functional range. Grip strength was also significantly reduced (Table 1). Results of the radiographical measurements are shown in Table 2. No significant differences are seen here.
Table 1
ROM and grip strength of the operated hand compared to the contralateral side
Mean (range) | p-value | ||
|---|---|---|---|
Operated hand | Normal hand | ||
Flexion | 50 (20–75) | 74 (40–90) | <0.001 |
Extension | 51 (28–90) | 71 (45–100) | <0.001 |
Ulnar deviation | 33 (30–50) | 42 (25–50) | <0.001 |
Radial deviation | 19 (10–30) | 29 (20–50) | <0.001 |
Grip strength | 39 (21–61) | 47 (26–71) | <0.001 |
Table 2
Preoperative radiological measurements compared to postoperative values
Mean (range) | p-value | ||
|---|---|---|---|
Preoperative | Postoperative | ||
SL angle | 66.5 (32.9–94.4) | 61.9 (30–97.2) | 0.03 |
SL interval | 3.3 (1.5–7.9) | 2.9 (1.5–5.4) | 0.15 |
Nattrass coefficient | 1.394 (1.27–1.51) | 1.385 (1.22–1.55) | 0.41 |
4 Discussion
Isolated rupture of the scapholunate ligament leads to dynamic scapholunate instability. If the scaphotrapeziotrapezoidal ligament and the dorsal radiotriquetral ligament are also damaged, a static scapholunate instability occurs [3].
In 1995, Brunelli and Brunelli [2] designed a new technique using a FCR tendon slip to reduce the scaphoid, correct the scapholunate dissociation and restore carpal height. They report on 13 cases with a short follow-up period of maximum 2 years. There is a limitation in wrist flexion of 30–60 % compared to the contralateral wrist and a limitation in grip strength of mean 35 % less than the contralateral hand. All 13 patients could return to work, 11 had no pain left and all 13 patients were satisfied.
Related posts:
Criteria to Date Traumas
Brunelli’s Tenodesis
Scapholunate Capsulodesis: Viegas’ Technique
of Normal Anatomy and Injuries of Extrinsic Ligaments
Capsulo-Fibrodesis: Horizontal Proximal Carpal Row Retightening Capsulodesis with Scapholunate ‘Fibrodesis’ – A New Surgical Option for Scapholunate Dissociation
of Open Scapholunate Ligament Repair
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