Dorsal capsulodesis and ligamentoplasty for chronic pre-dynamic and dynamic scapholunate dissociation.

Abstract

Scapholunate (SL) instability is the most common cause of carpal instability. Pre-dynamic and dynamic type SL instability is difficult to diagnose and treat. This series reviews 17 soldiers with pre-dynamic or dynamic SL instability diagnosed by midcarpal arthroscopy and treated with dorsal capsulodesis and augmentation ligamentoplasty with partial dorsal radiocarpal (DRC) ligament procedure between 1997 and 2000. The sample included 14 males and three females. The dominant hand was involved in 15 patients. Moreover, the average patient age was 29.3 years (range 19-36 years). The diagnosis was based on clinical and arthroscopic criteria. Fifteen patients were followed up at our clinic regularly, with the follow-up period ranging from 12 to 39 months (mean 25.2 months). Fourteen patients had excellent or good results, and one patient had poor result based on Mayo Modified Wrist Score. Wrist motion in the flexion-extension plane loss averaged 18.4 degrees. Grip force increased significantly following treatment, with improvement totaling 15% of normal side. No complications were found in this series. Consequently, dorsal capsulodesis and ligamentoplasty with partial DRC ligament is considered a valuable therapeutic option for cases of pre-dynamic and dynamic SL instability.