Chronic scapholunate instability treated with temporary screw fixation.

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery
• Sports Medicine

Background:

• Chronic scapholunate (SL) instability often requires surgical intervention to restore wrist function.
• Scapholunate ligament injuries can lead to significant pain and loss of motion.
• Maintaining reduction of the SL interval is crucial for successful treatment outcomes.

Purpose of the Study:

• To evaluate the efficacy of temporary scapholunate (SL) screw fixation in preserving the reduction of the SL interval.
• To assess the clinical and functional outcomes following SL screw fixation combined with ligamentous procedures.
• To determine the complication rate associated with this surgical technique.

Main Methods:

• A cohort of 36 patients with chronic SL instability underwent arthroscopic debridement for dynamic instability or primary repair/reconstruction for static instability.
• Temporary SL screw fixation was employed to protect the repaired or reconstructed SL ligament.
• Screws were removed upon radiographic evidence of loosening; follow-up averaged 7.9 years.

Main Results:

• The average patient age was 43 years, with 11 dynamic and 25 static instability cases.
• Postoperative radiographic parameters showed an average SL angle of 56° and an SL gap of 2.5 mm, maintained at final follow-up.
• Approximately 95% of patients reported mild pain, with good wrist range of motion; DISI deformity persisted in 2 patients.

Conclusions:

• Temporary SL screw fixation, alongside arthroscopic debridement and ligament repair/reconstruction, provides stable closure of the SL interval.
• This combined approach results in satisfactory clinical and functional outcomes.
• The technique demonstrates a low incidence of complications for treating chronic SL instability.