Anatomical Description of the Dorsal Capsulo-Scapholunate Septum (DCSS)-Arthroscopic Staging of Scapholunate Instability after DCSS Sectioning.
Background The dorsal capsuloligamentous scapholunate septum (DCSS) is a confluence of the dorsal capsule, the dorsal intercarpal ligament (DIC), and the scapholunate interosseous ligament (SLIOL). It appears to play a role in the stability of the scapholunate articulation. The purpose of this study was to describe the anatomical basis for this structure and to investigate its role in scapholunate instability through sectioning of this structure followed by an arthroscopic and fluoroscopic analysis. Material and Methods In the anatomical part of the study we dissected 3 fresh cadaver wrists to examine the anatomy of the DCSS. In the arthroscopic part of the study we assessed the EWAS grade of SL instability before and after sectioning the DCSS and measured the scapholunate and radiolunate angles fluoroscopically. Results Sectioning the DCSS increased the EWAS grade of SL instability but did not affect the scapholunate gap, the scapholunate angle or radiolunate angle. Conclusion We have demonstrated that there is a distinct structure that is separate from the dorsal capsule, which we have labeled the Dorsal Capsuloligamentous Scapholunate Septum. We believe that the DCSS is a previously unreported secondary stabilizer of the SL joint which may have therapeutic and prognostic implications.
Hand and Foot Surgery Unit, Tournai, Belgium.
Luc Van
LV
Overstraeten
SELARL Chirurgie de la Main, polyclinique du Val de Sambre, Maubeuge, France.
Emmanuel J
EJ
Camus
Division of Upper Extremity, Hand and Microvascular Reconstructive Surgery, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India.
Abhijeet
A
Wahegaonkar
Istitulo ortopedico Gaetano Pini, Milano, Italy.
Jane
J
Messina
Heidelberg University Hospital, Frankfurt, Germany.
Andrea A
AA
Tandara
Clinique Jouvenet, Institut de la main, Paris, France.
Adeline Cambon
AC
Binder
Clinique Jouvenet, Institut de la main, Paris, France.
Christophe L
CL
Mathoulin
DCSS; capsuloScapholunate Septum; scaphoLunate Instability; scapholunate complex