Dynamic correction of scapholunate instability using ECRB tendon transfer

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Musculoskeletal Biomechanics

Background:

• Scapholunate instability, characterized by a fissure between scaphoid and lunate bones (SLD), is often linked to scapholunate ligament injuries (SLIL).
• Traditional SLIL repair yields suboptimal outcomes, with frequent SLD recurrence and potential for joint overloading.
• Persistent instability can lead to further joint damage and functional deficits.

Purpose of the Study:

• To evaluate the preliminary outcomes of a novel surgical technique for scapholunate instability.
• To assess the efficacy of partial extensor carpi radialis brevis (ECRB) tendon transfer for dynamic stabilization of the scaphoid.

Main Methods:

• A prospective study involving 7 patients with scapholunate instability.
• Surgical intervention included a partial ECRB tendon transfer to the distal pole of the scaphoid.
• Patient-reported outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.

Main Results:

• The ECRB tendon transfer resulted in improved scaphoid alignment and dynamic stabilization.
• Patients reported significant pain reduction and enhanced grip strength.
• No limitations in wrist flexion were observed post-operatively.

Conclusions:

• Preliminary results suggest that dynamic transfer of the ECRB tendon is an encouraging treatment for scapholunate instability.
• This technique offers a viable option for dynamic stabilization of rotatory scaphoid instability in predynamic and dynamic cases.
• Further research is warranted to confirm long-term efficacy and compare with existing treatments.