[New bone-ligament-bone transplant from plantar plates of the toes and possible use in reconstruction of the scapholunate ligament. An anatomical study].
BACKGROUND
Various treatment options have been proposed for reconstruction of the scapholunate ligament. However, none of these methods prevent patients with scapholunate instability from developing wrist arthritis. This study was performed to investigate a new bone-ligament-bone autograft from the plantar plate of the toes for suitable reconstruction of the scapholunate interosseus ligament. The anatomical properties and the technical feasibility were investigated.


METHODS
The plantar plates of the metatarso-phalangeal joints and the proximal interphalangeal joints of the 2nd-5th toes were examined in 20 cadaver feet and measurements such as length, thickness and width were recorded.


RESULTS
The average lengths of the plantar ligaments of the proximal interphalangeal joint were 0.63 cm (D3) and 0.62 cm (D4), respectively and were therefore found to be similar to that of the scapholunate ligament. Bone-ligament-bone autografts of the plantar plates were designed and intercalated between the scaphoid and lunate bones and, contrary to all previous methods, not simply superimposed upon them.


CONCLUSIONS
It can be concluded from the data that this new graft of the proximal interphalangeal joint of the 3rd and 4th toes can be a suitable replacement for the scapholunate ligament.
Reik
M
M
Klinik für Plastische, Hand- und Rekonstruktive Chirurgie, Kliniken des Main-Taunus-Kreises GmbH, Lindenstr. 10, 65719, Hofheim. mreik@kliniken-mtk.de
Germann
G
G
Sauerbier
M
M
Müller
M
M
D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008022:Ligaments / Q000601:surgery* / Q000637:transplantation*; D012667:Lunate Bone / Q000033:anatomy & histology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D021361:Scaphoid Bone / Q000033:anatomy & histology* / Q000601:surgery*; D014034:Toes / Q000033:anatomy & histology* / Q000637:transplantation