Dorsal intercarpal ligament capsulodesis for chronic, static scapholunate dissociation: Clinical results

• Published in: The Journal of hand surgery (American ed.) Vol. 27; no. 6; pp. 978 - 984
• Main Authors: Szabo, Robert M., Slater, Robert R., Palumbo, Carl F., Gerlach, Todd
• Format: Journal Article
• Language: English
• Published: New york, NY Elsevier Inc 01-11-2002; Elsevier; Elsevier Science Ltd
• Subjects: Adolescent; Adult; Biological and medical sciences; capsulodesis; Carpal Bones - surgery; Carpal instability; Chronic Disease; Female; Hand Strength - physiology; Humans; Joint Capsule - surgery; Joint Dislocations - surgery; Joint Instability - surgery; ligament tear; Ligaments, Articular - surgery; Lunate Bone - injuries; Lunate Bone - surgery; Male; Medical sciences; Middle Aged; Orthopedic Procedures - methods; Orthopedic surgery; Patient Satisfaction; Prospective Studies; Range of Motion, Articular - physiology; Scaphoid Bone - injuries; Scaphoid Bone - surgery; scapholunate dissociation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Treatment Outcome; wrist; Wrist Injuries - surgery; Wrist Joint - surgery; capsulodesis; ligament tear; scapholunate dissociation; Carpal instability; wrist; Juxtaarticular disease; Human; Ligament; Luxation; Prognosis; Diseases of the osteoarticular system; Carpus(bone); Recurrent; Trauma; Joint capsule; Biomechanics; Os naviculare carpi; Orthopedic surgery; Treatment; Disease of the hand; Tissue rupture; Upper limb; Lunate bone; Technique
• ISSN: 0363-5023; 1531-6564
• DOI: 10.1053/jhsu.2002.36523

The purpose of this study was to review and report the results of using a new procedure, the dorsal intercarpal ligament capsulodesis (DILC), to treat a group of patients with chronic flexible scapholunate dissociation. This was a prospective study of 21 patients (22 wrists), ranging in age from 16 to 62 years followed up for 1 to 4 years. For this study all patients returned to complete a questionnaire and have a physical examination performed by physicians and therapists independent of the treating surgeons and to obtain standardized radiographs of the wrists. Patient demographics, mechanism of injury, range of motion, and grip strength were recorded. Patients completed the Mayo wrist, Short-Form (SF)-12, and Disabilities of Arm, Shoulder and Hand (DASH) questionnaires. Results showed there were significant improvements in scapholunate angle and scapholunate gap at final follow-up examination, with minor loss of range of motion and grip strength. Patients were satisfied with the outcomes, showing an average score of 17 on the DASH and 83 on the SF-12. The DILC procedure is a reasonable option for treating chronic scapholunate dissociation. The procedure has conceptual advantages to recommend it: it avoids a tether between radius and scaphoid and keeps the proximal carpal row linked as a functional unit. It reduces the scapholunate angle and gap. Overall the results to date are quite encouraging.