Dorsal radiocarpal ligament capsulodesis for chronic dynamic lunotriquetral instability.
OBJECTIVE
Chronic lunotriquetral (LT) instability (persisting >3 months after injury) can be treated with a variety of surgical methods (LT fusion, ligament repair or reconstruction, or arthroscopic debridement), with varying degrees of success. We retrospectively evaluated the results of dorsal capsulodesis using the dorsal radiocarpal ligament in an attempt to reinforce the dorsal LT interosseous ligament in patients with chronic dynamic LT instability.


METHODS
A total of 11 patients (mean age, 37 years) with persistent posttraumatic wrist pain and weakness were diagnosed with dynamic LT instability (positive LT ballotment test, disruption of Gilula's lines or volar intercalated segment instability deformity on stress radiography, arthroscopic findings of Geissler grade 3, or 4 LT tears). They were treated consecutively with dorsal capsulodesis. We used subjective and functional outcome measures to evaluate the results.


RESULTS
The mean follow-up period was 31 months (range, 12-65 months). The postoperative visual analog pain score and Mayo wrist score were significantly improved compared with their preoperative values. The average grip strength increased by 5 kg, and the average range of wrist flexion was reduced by 3 degrees .


CONCLUSIONS
In this small series, in the short term, dorsal radiocarpal ligament capsulodesis reduced pain and instability and improved function in patients with chronic dynamic LT instability.


METHODS
Therapeutic IV.
Omokawa
Shohei
S
Department of Orthopedics, Ishinkai-Yao General Hospital, Affiliated Hospital of Nara Medical University, Osaka, Japan. omokawa@gaia.eonet.ne.jp
Fujitani
Ryotaro
R
Inada
Yuji
Y
D000293:Adolescent; D000328:Adult; D050824:Carpal Joints / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D012667:Lunate Bone / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D051221:Triquetrum Bone / Q000503:physiopathology / Q000601:surgery*; D014955:Wrist Joint / Q000503:physiopathology / Q000601:surgery