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Dorsal scapholunate stabilization using Viegas' capsulodesis: 25 cases with 26 months-follow-up
E J Camus1, L Van Overstraeten2
1SELARL chirurgie de la main et du pied, clinique du Val-de-Sambre, 162, route de Mons, 59600 Maubeuge, France.
Chirurgie De La Main
|November 12, 2013
Summary
Viegas' capsulodesis effectively reconstructs the scapholunate interosseous (SLIO) ligament, improving wrist function and reducing pain. This technique offers a stable solution for SLIO ligament lesions without causing stiffness.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Sports Medicine
Background:
- Intercarpal instability frequently results from scapholunate interosseous (SLIO) ligament lesions.
- Traditional capsulodesis methods for SLIO reconstruction may not preserve wrist isometry.
- The Viegas technique aims to replicate physiologic ligamentous isometry during wrist reconstruction.
Purpose of the Study:
- To evaluate the efficacy of the Viegas capsulodesis technique for reconstructing scapholunate interosseous (SLIO) ligament lesions.
- To compare preoperative and postoperative functional outcomes in patients undergoing SLIO ligament reconstruction.
- To assess the safety and technical feasibility of the Viegas capsulodesis procedure.
Main Methods:
- A cohort of 25 patients with SLIO ligament lesions underwent Viegas capsulodesis between 2006 and 2010.
- Patients presented with pain, reduced grip strength, limited mobility, or wrist clicking.
- Outcomes were assessed by comparing pre- and post-operative range of motion, grip strength, pain scores (VAS), and patient-reported wrist evaluation (PRWE).
Main Results:
- Significant improvements were observed in flexion/extension range (+2.6°), radioulnar deviation (+21.1°), and grip strength (+8.7 kgf).
- Patient-reported outcomes showed a decrease in pain (VAS: -3 points) and improvement in PRWE scores (-59 points).
- Complications included four cases of complex regional pain syndrome (CRPS), one extensor pollicis longus (EPL) lesion, and one superficial pin infection.
Conclusions:
- Viegas capsulodesis is an effective and technically manageable surgical option for treating difficult or irreparable SLIO ligament lesions.
- The technique provides effective wrist stabilization without inducing stiffness, leading to improved functional outcomes and patient satisfaction.
- Careful attention to surgical technique is necessary to minimize risks such as CRPS and pin-related complications.
