Blatt dorsal capsulodesis for scapholunate instability

This retrospective series reviews 17 patients with scapholunate instability treated with the Blatt procedure between 1994 and 1997. Indications were 11 cases of preradiographic instability, three dynamic and three static instabilities. Subjective and objective assessment was carried out. Average pain and level of activity score was 60.8/80 (good). Only three patients failed to continue their jobs. Ten patients were fully satisfied, and seven had minor to major reservations. Flexion loss averaged 11 degrees and extension loss was 11.3 degrees. Grip force improved significantly by 11.2 kg. Associated scapholunate interosseous ligament repair in 6 patients resulted in no further improvement. Major complications were deep infection (one case) and reflex sympathetic dystrophy (two cases). Given the lack of a superior procedure, we considered the Blatt capsulodesis a valuable therapeutic option for cases of preradiographic and dynamic instability, or as an adjunct to scapholunate interosseous ligament repair in more acute lesions.