title: Long-term results of dorsal intercarpal ligament capsulodesis for the treatment of chronic scapholunate instability.
abstract: The purpose of this study was to assess the clinical   and radiological outcomes of dorsal intercarpal ligament capsulodesis   for the treatment of static scapholunate instability at a minimum   follow-up of four years. A total of 59 patients who underwent capsulodesis   for this condition were included in a retrospective analysis after   a mean of 8.25 years (4.3 to 12). A total of eight patients underwent   a salvage procedure at a mean of 2.33 years (0.67 to 7.6) and were   excluded. The mean range of extension/flexion was 88° (15° to 135°)   and of ulnar/radial deviation was 38° (0° to 75°) at final follow-up.   The mean Disabilities of the Arm Shoulder and Hand (DASH) score   and Mayo wrist scores were 28 (0 to 85) and 61 (0 to 90), respectively. After   significant improvement immediately post-operatively (p < 0.001   and p = 0.001, respectively), the mean scapholunate and radiolunate   angles deteriorated to 70° (40° to 90°) and 8° (-15° to 25°), respectively,   at final follow-up, which were not significantly different from   their pre-operative values (p = 0.6 and p = 0.4, respectively).   The mean carpal height index decreased significantly from 1.53 (1.38   to 1.65) to 1.48 (1.29 to 1.65) indicating progressive carpal collapse   (p < 0.001); 40 patients (78%) had radiological evidence of degenerative   arthritis. Capsulodesis did not maintain carpal reduction over time. Although   the consequent ongoing scapholunate instability resulted in early   arthritic degeneration, most patients had acceptable long-term function   of the wrist.
authors.affiliation: Clinic for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. kai.megerle@mri.tum.de
authors.forename: K
authors.initials: K
authors.lastname: Megerle
authors.forename: D
authors.initials: D
authors.lastname: Bertel
authors.forename: G
authors.initials: G
authors.lastname: Germann
authors.forename: M
authors.initials: M
authors.lastname: Lehnhardt
authors.forename: S
authors.initials: S
authors.lastname: Hellmich
mesh_terms: D000293:Adolescent; D000328:Adult; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017746:Joint Capsule / Q000000981:diagnostic imaging / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery*; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult