gms | German Medical Science

Objectives/Interrogation: To evaluate the results of the arthroscopic reconstruction for the treatment of the scapholunate instability of the wrist

Methods: 31 patients were treated, with a mean age of 39.9 (22-51) years old. The mean time of symptoms before surgery was 6.9 (1-18) months. All patients were operated using the arthroscopic ligamentoplasty technique according to Corella. Only the dorsal escafolunate ligament was reconstructed. Kirschner wires fixation was not used. The wrist was immobilized for 2 weeks, followed by a progressive rehabilitation protocol. Preoperative and postoperative clinical and radiological parameters were evaluated. The mean follow-up was 16,2 (8-24) months.

Results and Conclusions: 4 patients had an Outbridge grade IV chondral lesion greater than 5 mm and the reconstruction was not performed. The ligamentoplasty was performed in 27 cases. 6 patients (22,2%) had associated lesions: 3 TFCC lesions and 2 LT instability. The range of flexo-extension was 141.6º before surgery and 127.4º in the post-operative period. Watson test was positive in 93% pre-operative period and only in 8% at the end of FU. Pain (EVA 0-10) decreased from 5.5 (3-7) to 1.9 (0-8). Scapholunate angle decreased from 73,8º (60-90º) to 64º (35-90º), DISI deformity was present in 100% before surgery and only in 46% at the end of FU. The Scapholunate gap decreased from 3.8 to 2.3 mm. All patients returned to their previous sports activity. There were no reoperations. 2 patients has complications at the end of FU: 1 median nerve injury by the volar approach and 1 persistent ulnar border pain.

The treatment of scapholunate instability with arthroscopic assisted repair presents good clinical and radiological results with a short period of recovery.