Open Treatment of Acute Scapholunate Instability

Acute treatment of scapholunate instability is important to prevent future complications of dorsal intercalated segment instability and scapholunate advanced collapse. An understanding of the fundamental normal and abnormal mechanics of this problem is vital. Diagnosis in the acute phase is based on clinical and radiographic findings and treatment focuses on primary scapholunate interosseous ligament repair with a reinforcing dorsal capsulodesis. Suture anchor repair with a modified "double-dorsal" capsulodesis is described. Current data show that open repair is a viable option in the acute setting with most patients demonstrating good to excellent functional, clinical, and radiographic results.