Abstract
Background Dorsal scaphoid translation (DST) has been demonstrated to occur in patients with
complete scapholunate interosseous ligament (SLIL) tears. Radiographs and magnetic
resonance imaging (MRI) have demonstrated ability to detect DST in patients with documented
complete scapholunate (SL) disruption, but the relevance of this parameter to outcomes
of reconstruction has not been determined.
Purpose The purpose of this article is to determine how radiographic parameters of SL dissociation
correlate with postoperative pain and functional outcomes of SLIL reconstruction.
Methods We performed a retrospective review of prospectively collected data on a cohort of
14 patients who underwent SLIL repair or reconstruction. Preoperative data included
radiographic measurements of carpal posture and alignment (SL angle, radiolunate [RL]
angle, SL gap, and DST), self-reported measure of average pain on a numerical rating
scale (NRS) of 0 to 10, and the patient rated wrist evaluation (PRWE) survey. Postoperatively,
the same data were collected at each follow-up visit. Radiographic parameters were
statistically compared with postoperative NRS pain score and PRWE scores. Statistical
correlations were calculated using Spearman's correlation coefficient, and mean NRS
pain scores were compared using Wilcoxon's rank-sum tests, with an α value of p = 0.05.
Results Mean NRS pain scores improved significantly after surgery. Mean DST improved significantly
after surgery. The presence of postoperative dorsal scaphoid translation (DST) correlated
strongly with postoperative pain. SL angle, RL angle, and SL gap showed no correlation
with patient reported pain. There was no correlation with any radiographic parameter
and PRWE.
Conclusions Our study demonstrates that the presence of DST in postoperative radiographs has
a strong correlation with patient reported pain following SLIL reconstruction. We
conclude that correction of dorsal translation of the scaphoid is a more sensitive
predictor of postoperative pain relief than SL gap, RL angle, or SL angle.
Level of evidence This is a Level IV study.
Keywords
scapholunate ligament reconstruction - dorsal scaphoid translation - scapholunate
interosseous ligament
