Outcomes of all-dorsal augmented intercarpal ligament reconstruction (ADAIR).

Abstract

Scapholunate (SL) and lunotriquetral (LT) ligament injuries are frequently undiagnosed and can lead to progressive loss of wrist function and chronic pain. Many surgical reconstruction options exist, but outcomes are suboptimal and no superior approach has been established. Consecutive candidates for SL and/or LT ligament reconstruction utilizing an all-dorsal augmented intercarpal ligament reconstruction (ADAIR) were evaluated in this prospective case series. The Michigan Hand Questionnaire (MHQ), Patient-Rated Wrist Evaluation (PRWE), range of motion, and grip and pinch strength were administered preoperatively and at postoperative visits up to 12 months. Twenty-two patients (24 wrists) were included in the study, with 17 wrists followed to 6 months and 15 wrists to 12 months postoperatively. In the operated extremity, overall MHQ scores improved over 12 months by a mean of 17.2 points (p < 0.001). All MHQ domain scores except aesthetic and work domains showed significant improvement. Overall PRWE scores improved by 24.1 points by 12 months (p < 0.001). At 12 months, all clinical outcomes, including grip and pinch strength, wrist range of motion, and radiographic measurements were improved or similar to baseline. ADAIR demonstrated encouraging short-term patient-reported and functional outcomes, comparable to other intercarpal reconstructions despite its relative technical simplicity. ADAIR is a promising technique for improving outcomes in these challenging surgical cases.