Long-term results of dorsal intercarpal ligament capsulodesis for the treatment of chronic scapholunate instability.

Megerle, K; Bertel, D; Germann, G; Lehnhardt, M; Hellmich, S

doi:10.1302/0301-620X.94B12.30007

2012

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Title:: Long-term results of dorsal intercarpal ligament capsulodesis for the treatment of chronic scapholunate instability.
Document type:: Journal Article
Author(s):: Megerle, K; Bertel, D; Germann, G; Lehnhardt, M; Hellmich, S
Abstract:: The purpose of this study was to assess the clinical and radiological outcomes of dorsal intercarpal ligament capsulodesis for the treatment of static scapholunate instability at a minimum follow-up of four years. A total of 59 patients who underwent capsulodesis for this condition were included in a retrospective analysis after a mean of 8.25 years (4.3 to 12). A total of eight patients underwent a salvage procedure at a mean of 2.33 years (0.67 to 7.6) and were excluded. The mean range of extension/flexion was 88° (15° to 135°) and of ulnar/radial deviation was 38° (0° to 75°) at final follow-up. The mean Disabilities of the Arm Shoulder and Hand (DASH) score and Mayo wrist scores were 28 (0 to 85) and 61 (0 to 90), respectively. After significant improvement immediately post-operatively (p < 0.001 and p = 0.001, respectively), the mean scapholunate and radiolunate angles deteriorated to 70° (40° to 90°) and 8° (-15° to 25°), respectively, at final follow-up, which were not significantly different from their pre-operative values (p = 0.6 and p = 0.4, respectively). The mean carpal height index decreased significantly from 1.53 (1.38 to 1.65) to 1.48 (1.29 to 1.65) indicating progressive carpal collapse (p < 0.001); 40 patients (78%) had radiological evidence of degenerative arthritis. Capsulodesis did not maintain carpal reduction over time. Although the consequent ongoing scapholunate instability resulted in early arthritic degeneration, most patients had acceptable long-term function of the wrist.
Journal title abbreviation:: J Bone Joint Surg Br
Year:: 2012
Journal volume:: 94
Journal issue:: 12
Pages contribution:: 1660-5
Language:: eng
Fulltext / DOI:: doi:10.1302/0301-620X.94B12.30007
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/23188908
Print-ISSN:: 0301-620X
TUM Institution:: Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Plastische Chirurgie und Handchirurgie (Prof. Machens)Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)2012