Jnl Wrist Surg 2015; 04(04): 246-251
DOI: 10.1055/s-0035-1564984
Special Focus Section: Scapholunate Ligament Reconstruction
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Cable-Augmented, Quad Ligament Tenodesis Scapholunate Reconstruction

Gregory I. Bain
1  Department of Orthopaedic Surgery, Flinders University of South Australia, South Australia, Australia
,
Adam C. Watts
2  Department of Orthopaedics, Wrightington Hospital, Lancashire, United Kingdom
,
James McLean
3  Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia
,
Yu C. Lee
3  Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, Australia
,
Kevin Eng
4  Barwon Orthopaedic Research Unit, Geelong University Hospital, Geelong, Victoria, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
29 October 2015 (online)

Abstract

Maintaining reduction of the scapholunate interval after reconstruction can be difficult. The authors performed scapholunate reconstruction using tensionable suture anchors in 8 patients. The anchors provide a fixed cable that both fixes the graft, and reduces the scapholunate diastasis and maintains reduction. The flexor carpi radialis tendon graft stabilizes not only the volar scaphotrapezial ligament, and dorsal scapholunate ligament, but also the dorsal intercarpal and dorsal radiocarpal ligament. The Berger flap is closed using an ulnar advancement capsulodesis that further reinforces the dorsal intercarpal and dorsal radiocarpal ligament. The mean pain score improved from 5.8 to 2.1. Mean extension was 56° (91% of contralateral side), flexion 44° (70% of contralateral side), and grip strength was 41kg (95% of the contralateral side). The mean scapholunate angle was 71°, radiolunate angle 16° and scapholunate interval 3.0 mm. The cable augmented, quad ligament scapholunate ligament reconstruction offers theoretical advantages but long term follow up is required.