gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Early Experience with a Novel Synthetic Scapholunate Ligament Construct

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Benjamin Hope - Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
  • Mark Ross - Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
  • Ruby Strauss - Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
  • Greg Couzens - Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-796

doi: 10.3205/19ifssh1099, urn:nbn:de:0183-19ifssh10998

Veröffentlicht: 6. Februar 2020

© 2020 Hope 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 http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives/Interrogation: It is hypothesised that use of a woven polyurethane "artificial ligament" is suitable for reconstructing the scapholunate ligament. We have previously described the mini Lockdown, a technique for entirely transosseous passage of a tendon graft through the proximal row [1].

Methods: The mini Lockdown "artificial ligament" is anchored in the distal scaphoid, routed through drill holes in the proximal row and passed across the triquetro-hamate joint to be secured into the dorsal capitate. The proximal row tunnels are the same as employed in the "SLT" reconstruction [1]. The mini Lockdown is used in three SL ligament reconstruction situations:

1.
in place of temporary K-wire fixation following acute repair or late reconstruction,
2.
in conjunction with a strip of FCR via the same transosseous proximal row tunnels (an augmented SLT), or
3.
in isolation via the SLT tunnels (a mini Lockdown RASL).

Sixteen study participants (1 female, 7 non-dominant) of median age (range) of 41.5 (15 - 60) years who had the mini Lockdown procedure since July 2016 were assessed prior to surgery and at 3, 6 and 12 months after surgery. Measures included Visual Analogue Scale (VAS), Global Rating of Change (GRC), PRWHE and QuickDASH patient reported questionnaires, range of motion and strength measures Median time to follow-up (range) was 5 (3 - 12) months. Only the most recent follow-up equal or greater than 6 months is reported below.

Results and Conclusions: Patient-reported VAS median pain scores decreased from 46.0 to 10.0 and satisfaction increased from 13.5 to 87.0 from pre-operative assessment (n=16) to most recent follow-up (n=9). PRWHE and QuickDASH scores improved from 61.5 and 40 respectively at pre-operative assessment (n=16) to 21.0 and 15.9 at most recent follow-up (n=9). Active range of motion was assessed pre-operatively (n=13) and compared to most recent follow-up (n=9): median wrist flexion/extension decreased from 60/60° to 50/58°; supination/pronation increased from 85/89° to 88/90°; and median radial/ulnar deviation increased from 12/25° to 15/20°. Between pre-operative assessment (n=12) and most recent follow-up (n=9), grip and two-point pinch increased from 77.5% to 78.9% and 73.5% to 100% of the contralateral side respectively.

The mini Lockdown technique offers promising early results showing that it is capable of correcting and maintaining large and longstanding deformities. The design process is ongoing.


References

1.
Ross M, Loveridge J, Cutbush K, Couzens G. Scapholunate ligament reconstruction. Journal of Wrist Surgery. 2013;2(2):110-5.