Failures of the three-ligament tenodesis for chronic static scapholunate dissociation are due to insufficient reduction

We retrospectively reviewed 13 patients who had successfully undergone three-ligament tenodesis for scapholunate instability, and compared the radiological outcome with 14 failed cases. The scapholunate angle in the failed group increased from 73 degrees to 81 degrees with a scapholunate gap of 532 mm, compared to a decrease in the successful group from 76 degrees to 66 degrees with a scapholunate gap of 2.94 mm. Postoperative radiographs may thus have a prognostic value and can also be used if confronted with a patient with persisting symptoms after operation. Salvage procedures may offer a better solution when tenodesis has failed and reduction is insufficient on radiographs, and we believe that redo operations are not indicated, when the initial reduction already failed.