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J Wrist Surg 2020; 9(06): 487-492
DOI: 10.1055/s-0040-1713656
Scientific Article

Postoperative Pain Is Correlated with Scaphoid Dorsal Translation following Scapholunate Interosseous Ligament Reconstruction

Emil S. Vutescu 
1   Department of Orthopedic Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island
,
Scott W. Wolfe 
2   Department of Orthopedic Surgery, Hand and Upper Extremity Service, Hospital for Special Surgery, New York, New York
,
Kevin Sung
2   Department of Orthopedic Surgery, Hand and Upper Extremity Service, Hospital for Special Surgery, New York, New York
,
Rishabh Jethanandani 
2   Department of Orthopedic Surgery, Hand and Upper Extremity Service, Hospital for Special Surgery, New York, New York
,
Steve K. Lee
2   Department of Orthopedic Surgery, Hand and Upper Extremity Service, Hospital for Special Surgery, New York, New York
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Abstract

Background Dorsal scaphoid translation (DST) has been demonstrated to occur in patients with complete scapholunate interosseous ligament (SLIL) tears. Radiographs and magnetic resonance imaging (MRI) have demonstrated ability to detect DST in patients with documented complete scapholunate (SL) disruption, but the relevance of this parameter to outcomes of reconstruction has not been determined.

Purpose The purpose of this article is to determine how radiographic parameters of SL dissociation correlate with postoperative pain and functional outcomes of SLIL reconstruction.

Methods We performed a retrospective review of prospectively collected data on a cohort of 14 patients who underwent SLIL repair or reconstruction. Preoperative data included radiographic measurements of carpal posture and alignment (SL angle, radiolunate [RL] angle, SL gap, and DST), self-reported measure of average pain on a numerical rating scale (NRS) of 0 to 10, and the patient rated wrist evaluation (PRWE) survey. Postoperatively, the same data were collected at each follow-up visit. Radiographic parameters were statistically compared with postoperative NRS pain score and PRWE scores. Statistical correlations were calculated using Spearman's correlation coefficient, and mean NRS pain scores were compared using Wilcoxon's rank-sum tests, with an α value of p = 0.05.

Results Mean NRS pain scores improved significantly after surgery. Mean DST improved significantly after surgery. The presence of postoperative dorsal scaphoid translation (DST) correlated strongly with postoperative pain. SL angle, RL angle, and SL gap showed no correlation with patient reported pain. There was no correlation with any radiographic parameter and PRWE.

Conclusions Our study demonstrates that the presence of DST in postoperative radiographs has a strong correlation with patient reported pain following SLIL reconstruction. We conclude that correction of dorsal translation of the scaphoid is a more sensitive predictor of postoperative pain relief than SL gap, RL angle, or SL angle.

Level of evidence This is a Level IV study.

Keywords

scapholunate ligament reconstruction - dorsal scaphoid translation - scapholunate interosseous ligament

Note

The investigation performed at the Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY.




Publication History

Received: 02 December 2019

Accepted: 13 May 2020

Article published online:
29 July 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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