title: Four-bone ligament reconstruction for treatment of chronic complete scapholunate separation.
abstract: This study reviews the results of a four-bone ligamentous weave reconstruction for treatment of chronic complete scapholunate separation. This reconstruction between the radius, lunate, capitate, and scaphoid employs a dorsal and palmar approach weaving a long strip of the extensor carpi radialis brevis through the four bones reducing and stabilizing the scaphoid and lunate with a wire loop. Thirty-six consecutive cases of operated chronic complete scapholunate separation were evaluated in a 2- to 10-year follow-up. Average length of follow-up was 4.8 years. Average age was 34 years. Average postoperative range of motion was 52 degrees extension and 37 degrees flexion. Grip strength averaged 73% of the noninvolved side. All preoperative scapholunate gaps seen on radiographs were greater than 4 mm, at surgery greater than 1.0 cm, and the postoperative gaps radiographically averaged 3.3 mm. Eighty-six percent of patients returned to preinjury activities including heavy labor. The most significant finding was no x-ray evidence of advancing arthritic changes.
authors.affiliation: Department of Orthopaedics, University of Washington, Seattle.
authors.forename: E E
authors.initials: EE
authors.lastname: Almquist
authors.forename: A W
authors.initials: AW
authors.lastname: Bach
authors.forename: J T
authors.initials: JT
authors.lastname: Sack
authors.forename: S E
authors.initials: SE
authors.lastname: Fuhs
authors.forename: D M
authors.initials: DM
authors.lastname: Newman
mesh_terms: D000328:Adult; D002348:Carpal Bones / Q000293:injuries*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008022:Ligaments / Q000601:surgery*; D008297:Male; D013536:Suture Techniques; D013709:Tendon Transfer; D013710:Tendons / Q000601:surgery*; D013997:Time Factors; D014953:Wrist