gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016)

25.10. - 28.10.2016, Berlin

Capitatohamate Bone-Ligamentous-Bone Autograft In Surgical Treatment Of the Chronic Lunotriquetral Instability

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Petra Meluzinova - Clinic of traumatology, Masaryk hospital, Usti nad Labem, Czech Republic
  • Lubomír Kopp - Masaryk Krankenhaus, Unfallzentrum, Ustí nad Labem, Czech Republic

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016). Berlin, 25.-28.10.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocPO22-924

doi: 10.3205/16dkou685, urn:nbn:de:0183-16dkou6854

Veröffentlicht: 10. Oktober 2016

© 2016 Meluzinova et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Objectives: The aim of the study is to present indications and surgical technique of lunotriquetral reconstruction using autologous capitatohamate bone-ligamentous-bone graft in case of posttraumatic chronic lunotriquetral instability. Early radiographic and functional results of referred method are assessed.

Methods: Between years 2012 and 2014 there were performed 4 lunotriquetral reconstructions using referred method in patients in average 34 years of age (27-45). The indications included chronic dynamic instability of the lunotriquetral joint in three cases (grade II and III according to Hanker arthroscopical classification for lunotriquetral interosseous ligament joint injuries) and static volar intercalated instability (VISI) in one case (grade IV according to Hanker classification). The prospective follow-up lasted for an average of 2 years (1-4). The outcomes of surgery were evaluated on the basis of radiograms and multiplanar reconstructions of CT images, wrist function was assessed using Mayo Wrist Score a Quick DASH Questionnaire.

Results: The average wrist active range of motion was 85 % (100-76) of the contralateral unaffected side. Postoperative radiograms demonstrated anatomical position of the wrist in cases of dynamic instability without development of the degenerative changes of ulnocarpal and mediocarpal joint. Within the postoperative observation we recorded full stability of the lunotriquetral joint in these patients. In case of static volar intercalated instability we observed insufficiency of graft during period of two years. It resulted in recurrence of instability of the lunotriquetral joint with persistent clinical symptomatics, which resulted in the performance of lunotriquetral arthrodesis. The final functional outcomes assessed using the Mayo Wrist Score was 85 points (100-65) and using the QuickDASH Questionnaire was 12,5 points (29.5-0).

Discussion: Achieving an average ROM of wrist and functional outcomes after stabilization of the clinical status can be assessed as very satisfactory in patients with dynamic instability, also this method can be recommended for treatment of this type of chronic lunotriquetral instability. This method can not be recommended for treatment of chronic static lunotriquetral instability due to complex injury of the carpal ligaments, which leads to early failure of the graft.

Conclusions: From the results of early functional assessements and radiographic findings it can be concluded that the autologous capitatohamate bone-ligamentous-bone graft can be used in the treatment of posttraumatic chronic dynamic lunotriquetral instability (grade II and III according to Hanker arthroscopical classification for LTIL injuries).