Abstract
Chronic scapholunate ligament (SL) injuries are difficult to treat and can lead to wrist dysfunction. Whilst several tendon reconstruction techniques have been employed in the management of SL instability, SL gap reappearance after surgery has been reported. Using a finite element model and cadaveric study data, we investigated the performance of the Corella, scapholunate axis (SLAM) and modified Brunelli tenodesis (MBT) techniques. Scapholunate dorsal and volar gap and angle were obtained following virtual surgery undertaken using each of the three reconstruction methods with the wrist positioned in flexion, extension, ulnar deviation and radial deviation, in addition to the ulnar-deviated clenched fist and neutral positions. From the study, it was found that, following simulated scapholunate interosseous ligament rupture, the Corella technique was better able to restore the SL gap and angle close to the intact ligament for all wrist positions investigated, followed by SLAM and MBT. The results suggest that for the tendon reconstruction techniques, the use of multiple junction points between scaphoid and lunate may be of benefit.Graphical abstractThe use of multiple junction points between scaphoid and lunate may be of benefit for tendon reconstruction techniques.
Highlights
Scapholunate interosseous ligament (SLIL) injury is a relatively common [1, 2] wrist ligament condition which if not treated successfully may lead to carpal instability and degenerative osteoarthrosis [3]
Ligamentous reconstruction techniques including capsulodesis, bone-ligament-bone and tenodesis are an option where patients present with non-repairable SLIL injury but a reducible scapholunate ligament (SL) dissociation [5]
Tenodesis procedures have concentrated on reconstructing the dorsal component of SLIL volar opening and sagittal plan rotation leading to altered kinematics remains a potential complication [3, 5]
Summary
Scapholunate interosseous ligament (SLIL) injury is a relatively common [1, 2] wrist ligament condition which if not treated successfully may lead to carpal instability and degenerative osteoarthrosis [3]. SLIL injury occurs most frequently with the wrist positioned in extension, ulnar deviation and carpal supination. Treatment of scapholunate instability depends upon the severity of the injury which can vary widely [4]. SLIL reconstruction techniques, including the Brunelli tenodesis method and derivations [7,8,9], have concentrated on reconstructing only the dorsal portion of the SLIL; volar opening and sagittal plan rotation remains a potential complication, leading to altered kinematics [3, 5]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call