title: [Dorsal intercarpal ligament capsulodesis for chronic static scapholunate dissociation].
abstract: OBJECTIVE
  To investigate the radiographic and clinical outcomes of dorsal intercarpal ligament capsulodesis (DILC) procedure for chronic static scapholunate dissociation.
  
  
  METHODS
  Between January 2008 and January 2011, 12 patients with chronic static scapholunate dissociation were treated with DILC. Of 12 cases, 10 were male and 2 were female with an average age of 42 years (range, 20-66 years). All injuries were caused by falling. The interval from injury to surgery was 3-19 months (mean, 8 months). Physical examination at admission showed wrist tenderness and limited range of motion (ROM). Radiological examination showed that scapholunate gap was greater than 3 mm on posteroanterior view, and scapholunate angle more than 60° on the lateral view. Before operation, the grip strength was (25.4 ± 8.2) kg; the wrist ROM was (56.7 ± 11.5)° in flexion and (52.0 ± 15.2)° in extension; visual analogue scale (VAS) score was 6.3 ± 1.4; and disabilities of arm, shoulder & hand (DASH) score was 39.5 ± 7.4. According to Garcia-Elias staging criteria, all cases were rated as stage 4, indicating that the scapholunate interosseous ligament was completely injured and reduction could easily be obtained. Eight patients had wrist instability.
  
  
  RESULTS
  Primary healing of incision was achieved, no complication was found. All patients were followed up 13-34 months (mean, 15.9 months). During surgery, all deformities were corrected completely, but 7 patients (58%) recurred at 1 month after Kirschner wire removal. Compared with preoperative ones, the scapholunate gap, scapholunate angle, radiolunate angle, lunocapitate angle, and wrist height ratio at 1 month after Kirschner wire removal and last follow-up showed no significant difference (P > 0.05); the wrist flexion and extension ROM were significantly decreaed to (46.8 ± 7.2)° and (42.0 ± 9.0)° at last follow-up (P < 0.05); the grip strength was significantly increased to (32.7 ± 9.6) kg at last follow-up (P < 0.05); VAS score and DASH score were improved to 1.7 ± 1.0 and 8.1 ± 8.7 (P < 0.05).
  
  
  CONCLUSIONS
  Carpal collapse will recur in short time after DILC. DILC is not the best way to treat chronic static scapholunate dissociation.
authors.affiliation: Department of Hand Surgery, Beijing Jishuitan Hospital, P.R. China. 0414yang@sina.com
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.forename: Tusmin
authors.initials: T
authors.lastname: Tsai
authors.forename: Shanlin
authors.initials: S
authors.lastname: Chen
authors.forename: Zhongzhe
authors.initials: Z
authors.lastname: Li
authors.forename: Guanglei
authors.initials: G
authors.lastname: Tian
mesh_terms: D000058:Accidental Falls; D000328:Adult; D001864:Bone Wires; D002348:Carpal Bones / Q000601:surgery; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D018737:Hand Strength; 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; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*