Clinical, radiological and dynamic CT results of scapholunate intercarpal ligamentoplasty for scapholunate instability.

Fiche publication

Date publication

août 2024

Journal

Hand surgery & rehabilitation

Auteurs

Membres identifiés du Cancéropôle Est :
Pr TEIXEIRA GONDIM Pedro

Tous les auteurs :
Athlani L, Luc É, Pauchard N, Blum A, Dautel G, Gondim Teixeira PA

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/39127156

Résumé

Clinical, radiological and 4D computed tomography assessment of outcomes of scapholunate intercarpal ligamentoplasty was performed at a minimum 2 years' follow-up. Twenty-nine patients (23 men and 6 women) with a mean age of 40 years (range, 22-57) with chronic scapholunate instability were treated by scapholunate intercarpal ligamentoplasty: 18 with dynamic and 11 with static instability. Patients were evaluated at a mean follow-up of 61 months (range, 24-94). Scapholunate intercarpal ligamentoplasty significantly reduced pain and increased grip strength and wrist function. On radiographs, mean static and dynamic scapholunate gaps and scapholunate and radiolunate angles improved significantly. Dorsal scaphoid subluxation was corrected in all cases. Postoperative 4D computed tomography provided more precise analysis of efficacy in restoring intracarpal alignment. Correction of the dorsal intercalated segment instability and dorsal scaphoid subluxation was confirmed. Scapholunate intercarpal ligamentoplasty restored normal scapholunate gap range during radioulnar deviation movement without systematically reducing mean and maximum distance between the bones, which remained pathological in wrists with static but not dynamic instability. At the final follow-up, no patients had signs of radial and/or midcarpal osteoarthritis due to scapholunate advanced collapse. LEVEL OF EVIDENCE: III.