Abstract
Purpose This systematic review summarizes the existing evidence on treatment options and
outcomes for partial scapholunate interosseous ligament (pSLIL) injuries.
Methods A systematic electronic search of Medline, Embase, and CINAHL was performed from
inception through to February 13, 2022. All primary research articles addressing the
treatment of pSLIL tears were eligible for inclusion regardless of timing of surgery,
surgical technique, or rehabilitation. The PRISMA Checklist guided the reporting and
data abstraction. Descriptive statistics and forest plots are presented.
Results A total of 14 studies with 342 patients were included for analysis. Treatments were
categorized into four groups: electrothermal shrinkage (ES), arthroscopic capsuloplasty
(AC), open capsulodesis (OC), and no treatment (NT). There were five studies in the
ES group (N = 69, mean age = 34.3 ± 3.3 years), three studies in the AC group (N = 138, mean age = 32.2 ± 3.8 years), five studies in the OC group (N = 123, mean age of 30.7 ± 7.8 years), and one study in the NT group (N = 12, mean age = 43 years, range = 28–67 years). The average postintervention visual
analog scale pain score for the ES group was 1.4 ± 0.5 (from 5.7 ± 1.8), for the AC
group was 3.2 ± 1.3 (from 6.6 ± 0), for the OC group was 2.3 ± 2.1 (from 5.6 ± 1.6),
and for the NT group was 3.2 (from 7.6). The wrist extension range of motion improved
postoperatively for all intervention groups (ES = 66.3°–70.7°; AC = 67°–74.5°; and
OC = 48.9°–63.5°), whereas it remained unchanged for the NT group (46°–45°). Grip
strength also improved in all intervention groups (ES = 17.9–29.9 kg; AC = 24.0–32.2 kg;
and OC = 15.8–26.6 kg), while the NT group remained unchanged (25–24 kg). The radiographic
scapholunate gap improved postoperatively in all groups that reported pre- and postintervention
(ES = 2.2–1.9 mm; OC = 2.5–1.8 mm) and slightly worsened in the NT group (2.5–2.7 mm).
In the ES group, there were three complications (11.5%, no major complications), in
the AC group there was one major complication (0.9%, complex regional pain syndrome
[CRPS]), and in the OC group there were six complications (15.4%, four major complications—CRPS).
Conclusion All interventional treatment options (ES, AC, and OC) provided significant improvements
in patient-reported pain, range of motion, grip strength, and radiographic parameters,
with low complication rates. In comparison, no improvement in range of motion or grip
strength was noted in the NT group. Therefore, surgical management of pSLIL injuries
is an effective and relatively safe treatment option. Further studies comparing the
outcomes of specific surgical treatments are warranted to further elucidate the optimal
management option for pSLIL tears.
Level of Evidence Level III, systematic review of Level III–IV studies.
Keywords
scapholunate - capsulodesis - electrothermal shrinkage - capsuloplasty - wrist
