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[Ligament reconstruction for lunotriquetral instability using a distally based strip of the extensor carpi ulnaris
T Pillukat1, R A Fuhrmann2, J Windolf3
1Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland. t.pillukat@handchirurgie.de.
Objective:
Stabilization of the lunotriquetral junction.
Indications:
Dynamic and static chronic instability without fixed dislocation of the carpals.
Contraindications:
Chronically fixed dislocation of the carpals, ulnar impaction syndrome, osteoarthritis of the joint between hamate and triquetrum and other parts of the wrist joint, rheumatoid arthritis, chondrocalcinosis.
Surgical Technique:
Restoration of the palmar portion of the lunotriquetral ligament using a distally based strip of the extensor carpi ulnaris tendon with temporary fixation of the lunotriquetral junction with K-wires.
Postoperative Management:
Immobilization for 8 weeks with a radial cast that includes the first metacarpophalangeal joint. Removal of the K-wires after 8 weeks and exercise.
Results:
The procedure with rare complications reliably restores stability of the lunotriquetral junction. Reduction of grip strength, pain during exercise, and a reduced range of motion persist. Overall, the results are predominantly good and excellent.
