title: The modified Brunelli procedure for scapholunate instability: a single centre study.
abstract: Management of scapholunate (SL) instability remains controversial. The modified Brunelli procedure is a soft tissue procedure that recreates the stabilising forces of the SL ligament using a split flexor carpi radialis tendon graft passed from volar to dorsal via a tunnel in the distal pole of the scaphoid. Thirteen consecutive patients with an average age of 35 years underwent the modified Brunelli procedure. Pain improved from a mean visual analog score of eight preoperatively to 1.5. The DASH score improved from a preoperative score of 55.4 to 34.9 as did the grip strength from 40% to 75% respectively. All wrist ranges of motion were decreased post-operatively in particular wrist flexion. SL ligament reconstruction using the modified Brunelli procedure resulted in satisfactory outcomes. Post-operatively patients were relatively pain free, with improved grip strength. The range of motion was reduced postoperatively, however did not restrict return to work or premorbid activities.
authors.affiliation: Department of Orthopaedics, Our Lady's Hospital, Navan, Co-Meath, Ireland.
authors.forename: Prasad
authors.initials: P
authors.lastname: Ellanti
authors.forename: Gurudattsingh
authors.initials: G
authors.lastname: Sisodia
authors.forename: Abdulla
authors.initials: A
authors.lastname: Al-Ajami
authors.forename: Priyanka
authors.initials: P
authors.lastname: Ellanti
authors.forename: Paul
authors.initials: P
authors.lastname: Harrington
mesh_terms: D000328:Adult; D018737:Hand Strength; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D012667:Lunate Bone; D010147:Pain Measurement; D021361:Scaphoid Bone; D053656:Tenodesis / Q000379:methods*; D016896:Treatment Outcome; D014955:Wrist Joint / Q000601:surgery