title: Arthroscopic ligamentoplasty of the dorsal and volar portions of the scapholunate ligament.
abstract: Classical arthroscopic techniques for scapholunate instability consist of debridement, thermal shrinkage, and percutaneous pinning. Good results are obtained in acute lesions or in chronic partial tears, but they are less predictable when the lesion is complete, because of the poor healing capacity of the scapholunate ligament and because it is not possible to perform an anatomic ligamentous reconstruction with these techniques. Open techniques are thus required for reconstruction, but they damage the soft tissues. We recently published a description and cadaver study of an arthroscopic ligamentoplasty, trying to combine the advantages of arthroscopic techniques (minimally invasive surgery) and open techniques (reconstruction of the ligament). With this approach, it is possible to reconstruct the dorsal scapholunate ligament and the secondary stabilizers while causing minimal damage to the soft tissues and avoiding injury to the posterior interosseous nerve and detachment of the dorsal intercarpal ligament. The current report describes an additional step to this technique with which it is possible to reconstruct the volar portion of the scapholunate ligament. We also describe an early mobilization postoperative protocol that we believe is equally important.
authors.affiliation: Hand Surgery Unit, Orthopaedic and Trauma Department, Infanta Leonor University Hospital; and the Hand Surgery Unit, Beata Maria Hospital, Madrid, Spain. Electronic address: fernando.corella@gmail.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Corella
authors.forename: Miguel
authors.initials: M
authors.lastname: Del Cerro
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ocampos
authors.forename: Ricardo
authors.initials: R
authors.lastname: Larrainzar-Garijo
mesh_terms: D001182:Arthroscopy / Q000379:methods* / Q000534:rehabilitation; D002102:Cadaver; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery*; D012667:Lunate Bone / Q000293:injuries / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D020127:Recovery of Function; D021361:Scaphoid Bone / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Scapholunate instability; arthroscopic ligamentoplasty; scapholunate ligament; wrist arthroscopy