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Scapholunate Ligament Partial Tears; Tear Localization, Extrinsic Ligament Injury Association and Conservative
B Karaalioglu1, O Korkmaz2, K Yilmaz2
1İstanbul Medipol University Hospital, Department of Radiology, Istanbul, Turkey.
Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca
|March 12, 2023
Summary
Conservative treatment effectively reduces pain and improves function for partial scapholunate interosseous ligament (SLIOL) tears, especially in acute cases with intact secondary stabilizers. This approach is viable regardless of tear location or grade.
Area of Science:
- Orthopedics
- Radiology
- Sports Medicine
Background:
- Scapholunate interosseous ligament (SLIOL) tears often occur with extrinsic ligament injuries, leading to scapholunate (SL) instability.
- Understanding tear patterns and associated injuries is crucial for effective management.
Purpose of the Study:
- To analyze SLIOL partial tear characteristics, including localization, grade, and co-occurring extrinsic ligament injuries.
- To evaluate the effectiveness of conservative treatment for SLIOL tears based on injury type.
Main Methods:
- Retrospective evaluation of 104 patients with SLIOL tears without dissociation.
- Magnetic resonance (MR) imaging analysis of tear localization, grade, and extrinsic ligament involvement (RSC, LRL, STT, DRC, DIC).
- First-year follow-up of conservatively treated patients assessing pain (VAS) and function (DASH, PRWE).
Main Results:
- 79% of patients had SLIOL tears; 44% had accompanying extrinsic ligament injuries, mostly partial tears.
- Volar SLIOL tears were most common (45%). Dorsal intercarpal ligament (DIC) and radiolunotriquetral (LRL) injuries were frequent, correlating with volar and dorsal SLIOL tears, respectively.
- Extrinsic ligament injuries correlated with higher initial pain and disability scores, but treatment outcomes were similar across injury types; acute injuries showed better score reversal.
Conclusions:
- Imaging of SLIOL injuries should assess secondary stabilizers.
- Conservative treatment can achieve significant pain reduction and functional recovery in partial SLIOL tears.
- Conservative management is a suitable initial option for partial SLIOL injuries, particularly acute cases, if secondary stabilizers are intact.
