Arthroscopic treatment of acute scapholunate and lunotriquetral ligament injuries

Abstract

Acute scapholunate and lunotriquetral interosseous ligament injuries must be stabilized for anatomically correct healing to prevent progressive carpal instability. Shortcomings of reconstruction procedures place a priority on achieving a successful initial repair. The traditional repair strategy involves open reduction and internal fixation and results in significant long-term wrist stiffness. An attempt to produce less scarring with minimally invasive techniques is currently being made using arthroscopy to guide the reduction and fixation of the intercarpal relationships during repair. One of the most important aspects of managing intrinsic ligament injuries in the wrist is making an accurate evaluation of the injury magnitude and recognizing the importance of functional stability provided by the ligament. This article provides an injury grading method based on functional stress testing of the scapholunate and lunotriquetral interosseous ligaments. The details of the arthroscopic technique have not been firmly established by the limited number of authors that have reported on the subject to date. Furthermore, long-term results in high numbers of patients are not currently available to firmly establish the efficacy of arthroscopic treatment of acute perilunate injuries.