gms | German Medical Science

Introduction: Scapholunate instability is the most frequent carpal instability. It encompasses a spectrum of injuries which go from minor sprains to a complete disruption of the scapholunate interosseous ligament complex and the secondary stabilizers. It generates kinetic and kinematic changes in the carpus that can present with pain, range of motion restriction, difficulty with normal activities and limitations in loading and strength. Arthroscopy is the Gold Standard for diagnosis of scapholunate injuries. Amongst the treatment options for these injuries is the reconstruction technique described by Corella in 2014 which shows promising results with regards to range of motion, pain, strength and DASH scores.

Objective: We propose and evaluate a rehabilitation program for patients with complete scapholunate injuries arthroscopically reconstructed according to the Corella technique, evaluating pain, range of motion and functionality.

Material and Methods: We undertook a prospective evaluation of 8 patients with a complete injury of the scapholunate complex reconstructed arthroscopically with a free tendon according to the Corella technique from 2014 to 2018.

The patients started rehabilitation in the second week after the reconstruction with 3 sessions a week for a total of 40 sessions. The main difference with existing protocols is the use of Manual Therapy techniques regain the flexion and extension range of motion. We register the changes in DASH score, range of motion and pain.

Results: As a result of the application of the protocol, it is observed that the DASH score is between 0 and 5, pain between 0 and 1, flexion between 70º and 75º, extension between 70º and 80º.

Conclusions: The application of a Manual Therapy based rehabilitation protocol shows significant improvement in function, range of motion and pain relief in the operated wrist, with results comparable to the literature.