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J Wrist Surg 2023; 12(04): 345-352
DOI: 10.1055/s-0042-1759729
Scientific Article

Dorsal Scapholunate Ligament Reconstruction by Using Palmaris Longus Tendon Graft in Chronic Static Scapholunate Dissociations: Does It Yield Favorable Radiographic and Functional Results?

Yigit Erdag 
1   Department of Orthopedic Surgery and Traumatology, Emsey Hospital, Istanbul, Turkey
,
Tuna Pehlivanoglu 
2   Department of Orthopedic Surgery and Traumatology, Liv Hospital, Istanbul, Turkey
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Funding None.
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Abstract

Background Scapholunate (SL) instability is the most common dissociative carpal instability, and the most frequent cause of wrist osteoarthritis (OA), termed as scapholunate advanced collapse (SLAC). The aim of this study was to present the mid-term clinical and radiographic results of dorsal SL ligament reconstruction by utilizing free palmaris longus tendon graft in patients with symptomatic, chronic, static SL dissociation; while assessing the safety and efficacy of this technique,

Materials and Methods In total, 42 patients with a mean age of 44.1 (range 26–53) and mean follow-up duration of 69.4 months (range 60–72) with a diagnosis of chronic, static, and reducible SL instabilities with no chondral damage were enrolled. They all underwent dorsal SL ligament reconstruction with the exam same technique.

Results At the last follow-up, patients' mean preoperative SL gap improved from 4.7 (range 4–6) to 2.1 (range 2–3), as did SLA from 84 degrees (range 67–101 degrees) to 66 degrees (range 49–72 degrees)(p <0.001 for both). Preoperative mean VAS (visual analog score), DASH (Disabilities of the Arm, Shoulder and Hand), Mayo wrist scores and SF-36 scores showed significant improvements in the last follow-up visit (p <0.001, for all). No major complications were acquired in either of the patients.

Conclusion Dorsal SL ligament reconstruction by using free PL tendon graft was detected to provide successful restoration of the normal carpal alignment together with SL joint stability. This procedure, by significantly reducing pain and improving grip strength was detected to yield significantly improved clinical and functional outcomes, together with high patient satisfaction indicated by improved health-related quality of life (HRQOL) scores.

Level of Evidence IV.

Keywords

scapholunate dissociation - scapholunate ligament reconstruction - scapholunate gap - scapholunate angle - palmaris longus tendon graft - wrist osteoarthritis

Informed Consent

Patients were taken written informed consents regarding their participation in the study, including their preoperative, intraoperative, and postoperative clinical and radiographic images to be used for publication.


Ethical Approval

The present study received institutional review board approval.


Authors' Contributions

Y.E. contributed toward conceptualization, investigation, data collection, supervision, methodology, and manuscript preparation. T.P. contributed toward the study design, data collection, writing, manuscript preparation, statistical analysis, editing, validation, and formal analysis.




Publikationsverlauf

Eingereicht: 01. August 2022

Angenommen: 31. Oktober 2022

Artikel online veröffentlicht:
08. Dezember 2022

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