Extensor Carpi Radialis Longus Tenodesis Using a Biotenodesis Screw for Treatment of Symptomatic Geissler 2 Scapholunate Dissociation

Andrew Stone; Zuhaib Shahid; Sujit Agarwal; Tanaya Sarkhel

doi:10.1055/s-0039-1683943

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2019; 11(S 01): S53-S58
DOI: 10.1055/s-0039-1683943

Technical Note

Thieme Medical and Scientific Publishers Private Ltd.

Extensor Carpi Radialis Longus Tenodesis Using a Biotenodesis Screw for Treatment of Symptomatic Geissler 2 Scapholunate Dissociation

Authors

Andrew Stone

¹Department of Trauma and Orthopaedics, Ashford & St Peters Hospitals NHS Foundation Trust, Chertsey, Surrey, United Kingdom
Zuhaib Shahid

¹Department of Trauma and Orthopaedics, Ashford & St Peters Hospitals NHS Foundation Trust, Chertsey, Surrey, United Kingdom
Sujit Agarwal

¹Department of Trauma and Orthopaedics, Ashford & St Peters Hospitals NHS Foundation Trust, Chertsey, Surrey, United Kingdom
Tanaya Sarkhel

¹Department of Trauma and Orthopaedics, Ashford & St Peters Hospitals NHS Foundation Trust, Chertsey, Surrey, United Kingdom

Abstract

Treatment of scapholunate dissociation (SLD) depends on the degree of injury. We present our technique of extensor carpi radialis longus (ECRL) tenodesis for Geissler grade 2 SLD and our preliminary results. After arthroscopic confirmation of Geissler grade 2 SLD, we use a single incision and a polyetheretherketone (PEEK) anchor, attaching half of the ECRL tendon to the scaphoid. Preliminary results include improvements in QDASH, QDASH (work) and QDASH (sports/music), a median satisfaction level of 4/5 (satisfied), and a low complication rate. Our method is a safe, reproducible, and effective treatment of symptomatic Geissler grade 2 SLD that has failed nonoperative management, with technical advantages over alternative methods in the literature.

Keywords

scapholunate - extensor carpi radialis longus - tenodesis - biotenodesis - Geissler grade 2

Full Text

References

References
1 Linscheid RL, Dobyns JH, Beabout JW, Bryan RS. Traumatic instability of the wrist. Diagnosis, classification, and pathomechanics. J Bone Joint Surg Am 1972; 54 (08) 1612-1632
2 Short WH, Werner FW, Green JK, Masaoka S. Biomechanical evaluation of ligamentous stabilizers of the scaphoid and lunate. J Hand Surg Am 2002; 27 (06) 991-1002
3 Short WH, Werner FW, Green JK, Masaoka S. Biomechanical evaluation of the ligamentous stabilizers of the scaphoid and lunate: part II. J Hand Surg Am 2005; 30 (01) 24-34
4 Chennagiri RJ, Lindau TR. Assessment of scapholunate instability and review of evidence for management in the absence of arthritis. J Hand Surg Eur Vol 2013; 38 (07) 727-738
5 Geissler WB, Freeland AE, Savoie FH, McIntyre LW, Whipple TL. Intracarpal soft-tissue lesions associated with an intra-articular fracture of the distal end of the radius. J Bone Joint Surg Am 1996; 78 (03) 357-365
6 Caggiano N, Matullo KS. Carpal instability of the wrist. Orthop Clin North Am 2014; 45 (01) 129-140
7 Pappou IP, Basel J, Deal DN. Scapholunate ligament injuries: a review of current concepts. Hand (N Y) 2013; 8 (02) 146-156
8 Kitay A, Wolfe SW. Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am 2012; 37 (10) 2175-2196
9 Darlis NA, Weiser RW, Sotereanos DG. Partial scapholunate ligament injuries treated with arthroscopic debridement and thermal shrinkage. J Hand Surg Am 2005; 30 (05) 908-914
10 Bleuler P, Shafighi M, Donati OF, Gurunluoglu R, Constantinescu MA. Dynamic repair of scapholunate dissociation with dorsal extensor carpi radialis longus tenodesis. J Hand Surg Am 2008; 33 (02) 281-284
11 Kaltenborn A, Hoffmann S, Settje A, Vogt PM, Gutcke A, Rüttermann M. Modified minimally invasive extensor carpi radialis longus tenodesis for scapholunate dissociation: a prospective observational study. BMC Musculoskelet Disord 2017; 18 (01) 54
12 Peterson SL, Freeland AE. Scapholunate stabilization with dynamic extensor carpi radialis longus tendon transfer. J Hand Surg Am 2010; 35 (12) 2093-2100
13 Baratz ME, Dunn MJ, Berger RA, Weiss A. Hand Surgery. 1st ed.. Philadelphia, PA: Lippincott, Williams & Wilkins; 2004
14 De Carli P, Donndorff AG, Gallucci GL, Boretto JG, Alfie VA. Chronic scapholunate dissociation: ligament reconstruction combining a new extensor carpi radialis longus tenodesis and a dorsal intercarpal ligament capsulodesis. Tech Hand Up Extrem Surg 2011; 15 (01) 6-11
15 Weiss AP, Sachar K, Glowacki KA. Arthroscopic debridement alone for intercarpal ligament tears. J Hand Surg Am 1997; 22 (02) 344-349
16 Sherman SL, Copeland ME, Milles JL, Flood DA, Pfeiffer FM. Biomechanical evaluation of suture anchor versus transosseous tunnel quadriceps tendon repair techniques. Arthroscopy 2016; 32 (06) 1117-1124
17 Kennedy CA, Beaton DE, Solway S, McConnell S, Bombardier C. Disabilities of Arm, Shoulder and Hand (DASH). The DASH and QuickDASH Outcome Measure User's Manual. 3rd ed.. Toronto, Canada: Institute for Work and Health; 2011
18 Likert R. A technique for the measurement of attitudes. Arch Psychol 1932; 140: 1-55