Article
Acute scapholunate dissociation, “A” assembly an effective option for its treatment
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Authors
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Fidel Cayon
- Centro de Especialidades Ortopedicas, Quito, Ecuador
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Gabriel Alegria
- Centro de Especialidades Ortopedicas, Quito, Ecuador
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: To evaluate the result of the treatment with an "A" Assembly with percutaneous kirschner wires for the treatment of acute injuries of the scapholunate joint.
Methods: We performed a retrospective study for the evaluation of the results obtained with the"A" assembly for acute scapholunate dissociation. If we achieve an adequate reduction of the joint and we can maintain it during the acute scarring process, we will have a ligament that will be able to adequately fulfill its function. We propose the technique of an assembly in "A" with Kirschner wires for the treatment in acute, this technique consists of the placement of a first guide wire between the scaphoid and the lunate to help us as an axis for the closure of the affected joint in the trauma, once this is achieved we must also fix with a percutaneous wire the scaphoid towards the Capitate bone, this will act as an attachment element when placing the last wire from the lunate to the Capitate. We took all the patients operated by our team with this surgical technique from January 1, 2016 to June 30, 2018 and we evaluated the reduction obtained radiographically as well as the discomfort that the patient currently presents after the removal of the wires evaluating strenght, range of motion and pain.
Results and Conclusions: In 7 cases we have used the "A" assembly for the treatment of Scapholunate lesions, we have achieved reduction of the joint in 100% of the cases, verifying the same radiologically.
Radiological studies have been carried out with follow-up Immediately, one and 3 months after the injury, in 1 case a scapholunate dissociation was again identified in the third month, although clinically it remained asymptomatic. We evaluated the pain, range of motion and strength at 3 and 6 months, comparatively with the contralateral wrist. In the VAS scale the pain maintained an average of 2/10 (1-6) at 6 months post-trauma, the mobility arches reached an average of 80% (90-70) on the contralateral side and the strength reached 80% on the contralateral side.
The assembly in "A" in the acute injuries of the scapholunate joint is a valid treatment for its management, allowing an adequate primary healing of the ligaments, achieving pain relief, maintenance of the force and the range of motion in functional ranges.
