gms | German Medical Science

Objectives/Interrogation: All the many surgical techniques reported in medical literature for the reconstruction of the scapho-lunate ligament show benefits as well as complications, especially regarding stiffness. This study compares two dorsal capsuloplasty techniques widely used and validated for the treatment of chronic partial scapho-lunate ligament injuries: Berger/vs.Viegas techniques.

Methods: This is a retrospective study of 39 patients (25 females and 14 males) aged between 14 and 59 years (mean value 31.6yrs. ± 13.22) suffering from chronic partial scapho-lunate (SL) ligament injury corresponding to type III in Geissler's classification. They were divided into two groups of 20 subjects each; group A received Viegas' technique while group B received Berger' technique. All patients reported a history of direct blunt trauma to the wrist. Inclusion criteria were as follows: chronic partial tear of the ligament (Geissler type III); absence of joint chondropathy; follow-up up to 6 months. These were assessed both pre- and post-operatively by measuring function (PRWHE), grip strength (JAMAR), radio-lunate and scapho-lunate angles and by evaluating flexion-extension range of motion

Results and Conclusions: The outcome revealed clinically and statistically significant differences in favor of Viegas' technique in terms of recovery of autonomy, recovery of grip strength, reduction in the SL angle and, finally, recovery of wrist flexion. The study showed that Viegas' capsuloplasty is more effective than Berger's in terms of grip strength recovery, recovery of disability, range of motion, especially flexion, and correction of the carpal angles,especially the SL. The Authors believe that this is due to the biomechanical properties of Viegas technique. We also believe that this study also provides interesting information regarding the indication of one technique over the other to treat Geissler' type III lesions in relation to type of patient, work and sport activity performed.