Arthroscopic Assisted Reconstruction of LT-Ligament: A Description of a New TechniqueFunding None.
Background Injuries of the lunotrirquetral ligament (LT lig) could be part of an extensive carpal injury and are then often treated at the time of the injury. However, when an injury of the LT ligament occurs alone, the injury is often missed. Treatment of this injury has traditionally been by open surgery, such as reattachment of the LT ligament, ligament reconstruction, or arthrodesis of the LT joint. These procedures needed a large exposure to the carpus running the risk of damaging the external ligaments, the nerves important for proprioception, and the capsule with the potential of scarring and adhesions.
Materials and Methods We describe a novel arthroscopic assisted technique for reconstruction of the LT ligament. Using this less invasive technique, there is a possible advantage of lesser scarring and faster mobilization.
Results We have performed this technique in two patients with more than 30 months follow-up. They both have great improvement of the functional scores.
Conclusion The novel arthroscopic assisted technique for LT lig reconstruction is a technically demanding procedure; however, this obtains good clinical results with more than 30 months follow-up due to less exposure of the carpus.
Level of Evidence This is a Level IV, case series study.
For this article, no approval of Ethical Committee was necessary.
Eingereicht: 25. Juni 2020
Angenommen: 15. Juli 2020
Artikel online veröffentlicht:
14. September 2020
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- 1 Trumble TE, Bour CJ, Smith RJ, Edwards GS. Intercarpal arthrodesis for static and dynamic palmar intercalated segment instability. J Hand Surg Am 1988; 13A: 384-390
- 2 Murray PM, Palmer CG, Shin AY. The mechanism of ulnar-sided perilunate instability of the wrist: a cadaveric study and 6 clinical cases. J Hand Surg Am 2012; 37 (04) 721-728
- 3 Lindau T, Arner M, Hagberg L. Intraarticular lesions in distal fractures of the radius in young adults. A descriptive arthroscopic study in 50 patients. J Hand Surg [Br] 1997; 22 (05) 638-643
- 4 Sachar K. Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg Am 2008; 33 (09) 1669-1679
- 5 Slutsky DJ. Incidence of dorsal radiocarpal ligament tears in the presence of other intercarpal derangements. Arthroscopy 2008; 24 (05) 526-533
- 6 Cooney WP. Evaluation of chronic wrist pain by arthrography, arthroscopy, and arthrotomy. J Hand Surg Am 1993; 18 (05) 815-822
- 7 Haugstvedt JR. LT tears and arthroscopic repair. In: Piñal Fd, Mathoulin C, Nakamura T. eds. Arthroscopic Management of Ulnar Pain. Berlin; New York: Springer; 2012: 213-236
- 8 Shin AY, Battaglia MJ, Bishop AT. Lunotriquetral instability: diagnosis and treatment. J Am Acad Orthop Surg 2000; 8 (03) 170-179
- 9 Mathoulin C. ed. Wrist Arthroscopy Techniques. 2nd ed.. Stuttgart, New York, Delhi, Rio de Janeiro: Thieme; 2019