J Wrist Surg 2023; 12(02): 113-120
DOI: 10.1055/s-0042-1751078
Scientific Article

Arthroscopic Dorsal Ligamentocapsulodesis in the Management of Combined Tears of Scapholunate and Lunotriquetral Ligaments: Surgical Technique and Preliminary Clinical Results

1   Department of Orthopedics and Traumatology & Hand Surgery, Gaziosmanpaşa Hospital, Yeni Yüzyıl University, Istanbul, Turkey
,
2   Department of Orthopedics and Traumatology & Hand Surgery, Istanbul University, Istanbul, Turkey
,
3   Department of Orthopedics and Traumatology, Istanbul University, Istanbul, Turkey
,
4   Department of Hand Surgery, EMOT Hospital, İzmir, Turkey
,
1   Department of Orthopedics and Traumatology & Hand Surgery, Gaziosmanpaşa Hospital, Yeni Yüzyıl University, Istanbul, Turkey
› Author Affiliations
Funding None.

Abstract

Introduction The literature is scarce regarding the management of combined tears of scapholunate (SL) and lunotriquetral (LT) ligaments. This study aimed to evaluate our preliminary results with the arthroscopic dorsal ligamentocapsulodesis in managing such cases.

Materials and Methods Forty-two patients (13 females, 29 males; mean age = 31; age range = 18–51 years) who underwent arthroscopic dorsal ligamentocapsulodesis due to the combined tears of SL and LT ligaments were retrospectively reviewed. The mean follow-up was 38 (range = 24–55) months. The Modified Mayo Wrist Score, the visual analogue scale (VAS), and grip strength were assessed preoperatively and at the final follow-up examination.

Results The mean Modified Mayo Wrist Score significantly improved from 49 (range = 25–70) preoperatively to 82 (range = 60–100) at the final follow-up (p = 0.000). The mean VAS significantly decreased from 6.33 to 1.6 (p = 0.000). The mean hand grip strength significantly improved from 31 (range = 19–41) kg to 44 (range = 25–60) kg at the final follow-up examination (p < 0.001). No major complications were encountered.

Conclusion Arthroscopic dorsal ligamentocapsulodesis seems to be a safe and effective surgical technique in the management of this rare combined injury pattern.

Level of Evidence This is a Level IV, retrospective case series study.

Ethical Approval

The study was approved by local ethical committee.


Authors' Contributions

I.B.O.: Substantial contributions to the conception, design of the work, the acquisition, analysis, and interpretation of data for the work. O.A.: Substantial contributions to the conception, design of the work, the acquisition, analysis, and interpretation of data for the work. M.D.: Writing of the manuscript, the acquisition, analysis, and interpretation of data for the work. T.Y.: Analysis and interpretation of data for the work. M.U.: Substantial contributions to the conception, design of the work, and final approval of the version to be published.




Publication History

Received: 11 February 2022

Accepted: 24 May 2022

Article published online:
18 July 2022

© 2022. Thieme. All rights reserved.

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

 
  • References

  • 1 Pin PG, Nowak M, Logan SE, Young VL, Gilula LA, Weeks PM. Coincident rupture of the scapholunate and lunotriquetral ligaments without perilunate dislocation: pathomechanics and management. J Hand Surg Am 1990; 15 (01) 110-119
  • 2 Badia A, Khanchandani P. The floating lunate: arthroscopic treatment of simultaneous complete tears of the scapholunate and lunotriquetral ligaments. Hand (N Y) 2009; 4 (03) 250-255
  • 3 Mayfield JK, Johnson RP, Kilcoyne RK. Carpal dislocations: pathomechanics and progressive perilunar instability. J Hand Surg Am 1980; 5 (03) 226-241
  • 4 Pappou IP, Basel J, Deal DN. Scapholunate ligament injuries: a review of current concepts. Hand (N Y) 2013; 8 (02) 146-156
  • 5 van de Grift TC, Ritt MJ. Management of lunotriquetral instability: a review of the literature. J Hand Surg Eur Vol 2016; 41 (01) 72-85
  • 6 Ruch DS, Poehling GG. Arthroscopic management of partial scapholunate and lunotriquetral injuries of the wrist. J Hand Surg Am 1996; 21 (03) 412-417
  • 7 Mathoulin CL, Dauphin N, Wahegaonkar AL. Arthroscopic dorsal capsuloligamentous repair in chronic scapholunate ligament tears. Hand Clin 2011; 27 (04) 563-572 , xi
  • 8 Acar MA, Özdemir A, Eravsar E. Arthroscopic dorsal capsulodesis for isolated lunotriquetral interosseous ligament injuries. J Hand Surg Eur Vol 2021; 46 (05) 510-515
  • 9 Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clin Orthop Relat Res 1987; (214) 136-147
  • 10 Heller GZ, Manuguerra M, Chow R. How to analyze the Visual Analogue Scale: myths, truths and clinical relevance. Scand J Pain 2016; 13 (01) 67-75
  • 11 Geissler WB, Freeland AE, Savoie FH, McIntyre LW, Whipple TL. Intracarpal soft-tissue lesions associated with an intra-articular fracture of the distal end of the radius. J Bone Joint Surg Am 1996; 78 (03) 357-365
  • 12 Corella F, Del Cerro M, Ocampos M, Larrainzar-Garijo R. The “rocking chair sign” for floating lunate. J Hand Surg Am 2015; 40 (11) 2318-2319
  • 13 Özçelik İB, Uğurlar M, Kabakaş F, Purisa H. Arthroscopic dorsal ligamento capsulodesis results in Geissler grade 2 and 3 scapholunate interosseous ligament injuries [in Turkish]. Eklem Hastalik Cerrahisi 2015; 26 (01) 6-10