Carpal Realignment Using a Strip of Extensor Carpi Radialis Longus Tendon

Area of Science:

• Orthopedic Surgery
• Wrist Biomechanics
• Musculoskeletal Research

Background:

• Scapholunate instability is a common cause of wrist dysfunction and can progress to osteoarthritis if untreated.
• Existing surgical techniques for scapholunate instability have shown variable long-term success rates.
• Accurate reduction and reconstruction of scapholunate and scaphotrapezium-trapezoid ligaments are crucial for wrist stability.

Observation:

• A novel surgical technique is presented utilizing a distally based strip of the extensor carpi radialis longus.
• This technique facilitates improved reduction and maintenance of the scaphoid bone.
• The graft is used to reconstruct the volar and dorsal scapholunate ligament and the scaphotrapezium-trapezoid ligament.

Findings:

• The described technique effectively addresses scapholunate instability by providing robust ligamentous reconstruction.
• A clinical case demonstrated successful application with 17 months of follow-up, indicating sustained stability.
• The use of the extensor carpi radialis longus graft offers a promising method for restoring wrist function.

Implications:

• This technique offers a potential solution for managing scapholunate instability and preventing posttraumatic osteoarthritis.
• It may provide a more reliable method for reconstructing complex wrist ligament injuries.
• Further studies are warranted to evaluate the long-term efficacy and generalizability of this surgical approach.