Kinematic analysis of two scapholunate ligament reconstruction techniques

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Hand Surgery

Background:

• Scapholunate interosseous ligament (SLIL) injuries can lead to wrist instability.
• Surgical reconstruction aims to restore normal wrist kinematics.
• The modified Brunelli technique (MBT) and Mark Henry's technique (MHT) are two common SLIL reconstruction methods.

Purpose of the Study:

• To compare the kinematic effects of MBT and MHT for SLIL reconstruction.
• To evaluate the restoration of scapholunate (SL) and radiolunate (RL) angles and intervals after each procedure.

Main Methods:

• Ten cadaveric wrists were analyzed.
• Kinematic data (SL interval, SL angle, RL angle) were collected using a MicroScribe system.
• Measurements were taken in neutral, flexion, extension, and clenched fist positions under five conditions: intact, volar SLIL resection, whole SLIL resection, MBT reconstruction, and MHT reconstruction.

Main Results:

• Whole SLIL resection widened dorsal SL intervals, SL angle, and RL angle.
• Both MBT and MHT successfully restored dorsal SL intervals in all positions.
• Neither MBT nor MHT fully restored the volar SL interval, SL angle, or RL angle in specific positions.

Conclusions:

• MBT and MHT effectively restore the dorsal SL interval in cadaveric models.
• No significant kinematic differences were observed between MBT and MHT in this study.
• MBT may offer advantages in operative efficiency and reduced anterior structure injury compared to MHT.