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J Wrist Surg
DOI: 10.1055/a-2686-1118
Scientific Article

Long-Term Functional Outcomes After Volar Capsulodesis for Treatment of Scapholunate Ligament Injuries: An 18-Year Experience

Aida K. Sarcon 
1   Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
,
Paula A. Pino 
2   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
3   Department of Orthopedic Surgery, Pontifical Catholic University of Chile, Santiago, Chile
,
Sean R. Cantwell 
1   Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
4   Department of Plastic and Reconstructive Surgery, University of California, Irvine, California
,
Omar Selim 
2   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
,
Steven L. Moran
1   Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota
2   Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
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Funding This work received institutional support for funds.
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Abstract

Purpose

To present our clinical experience with a volar scapholunate (SL) ligament reconstruction using a strip of the long radiolunate ligament.

Materials and Methods

This was a single-institution observational study (2004–2022) of SL ligament injuries with evidence of a torn volar component on arthroscopy that received volar capsulodesis with/without a dorsal repair. The postoperative range of motion (ROM), grip strength, complications, and secondary surgery (e.g., four-corner fusion or total wrist fusion), and radiographic changes were reported. Disabilities of arm, shoulder, and hand/patient-rated wrist evaluation (DASH/PRWE) scores were prospectively collected. Patients were stratified by static versus dynamic/predynamic SL diastasis and by isolated volar versus volar and dorsal ligament injury.

Results

Twenty-eight patients (15 females and 13 males) with a mean age of 35.1 years (± 15.7) met the inclusion criteria. The follow-up was 86.3 months (± 53.4; minimum 11 months). Most (26/28) patients were right-handed. The majority (20/28) of the patients presented ≥ 6 weeks postinjury. Few (4/28) used tobacco. Most (20/28) patients had dynamic/predynamic injuries. Postoperatively, the mean pronation/supination was 83 degrees/83 degrees, flexion/extension was 56 degrees/61 degrees, ulnar deviation was 30 degrees, and radial deviation (RD) was 19 degrees (n = 13). The mean grip strength was 78.8% (± 30.4) of the contralateral normal side (n = 14). Except for increased RD in patients with dynamic/predynamic injuries (p = 0.02), there were no other ROM differences. SL widening (>3 mm) postoperatively was observed in 33.3% (2/6) of static versus none of the dynamic/predynamic injuries (p = 0.165). There were only two postoperative complications, both surgical site infections. Two patients had persistent pain and required secondary surgery at a median of 48 months. At 86.9 months, patients reported a mean DASH of 16.4 (± 17.8) and a PRWE of 24.6 (± 23.6), and 78.9% (15/19) returned to prior work.

Conclusion

We report long-term functional outcomes after a volar capsulodesis for volar SL injuries. This appears to be a safe procedure with an acceptable complication rate and low disability after 7 years. Most (approximately 79%) patients returned to their previous employment. A larger comparative study will be required to prove superiority to other types of repairs.

Level of Evidence

Level IV, Case series.

Keywords

volar - scapholunate injury - volar capsulodesis - interosseous ligament - clinical outcomes


Publication History

Received: 23 April 2025

Accepted: 19 August 2025

Article published online:
29 August 2025

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