146 Ligamentization and Remnant Integration: Implications for Scapholunate Reconstruction

Abstract

Abstract Introduction Scapholunate interosseous ligament (SLIL) injuries are common but remain a therapeutic challenge. Current treatment modalities prioritize restoration of normal anatomy with reconstruction where appropriate. To date, no reconstructive technique has been described that discusses the potential benefit of the preservation of the scapholunate ligament remnant. Little is known about the ‘ligamentization’ of grafts within the wrist. However, a growing body of knee literature suggests that remnant sparing may confer some benefit. In the absence of wrist specific studies, this literature must guide areas for potential augmentation of current surgical practices. Method We conducted a systematic review of the literature using Pubmed, Embase and Medline. Keywords were ‘Ligament’ AND ‘Reconstruction’ AND ‘Remnant’. We identified 366 original studies for title and abstract review. A total of 5 studies were included in the final analysis. Results In 5 animal studies, remnant stump integration resulted in enhanced ligamentization of grafted tissue as measured by vascularity, biomechanics, and proprioception. Conclusions Our review demonstrates a trend towards enhanced early ligamentization in grafts that incorporate the remnant stump. Remnant preservation is not currently performed in SLIL reconstruction and may provide an avenue for enhanced therapies. As such, it is a promising area for further, wrist specific, research.