Radiologic Evolution after Scapholunate Dorsal Capsulodesis for Chronic Tears

Area of Science:

• Orthopedic Surgery
• Wrist Arthroscopy
• Radiographic Analysis

Background:

• Chronic scapholunate (SL) injuries present ongoing management challenges.
• Arthroscopic dorsal capsulodesis has shown promise for clinical outcomes.
• Radiographic evaluation is crucial for assessing treatment efficacy.

Purpose of the Study:

• To evaluate the radiographic improvement of SL angles after arthroscopic dorsal capsulodesis.
• To determine if the radiographic correction is maintained over time.
• To assess the technique's impact on dorsal intercalated segment instability (DISI).

Main Methods:

• A cohort of 146 patients with SL instability (EWAS classification) underwent arthroscopic dorsal capsulodesis.
• Preoperative and serial postoperative (3, 6, 12 months) X-rays measured radiolunate (RL) and SL angles.
• Paired Student's t-test was used for statistical analysis.

Main Results:

• The SL angle decreased significantly by 74.3% (from 74.55 to 54.95 degrees) at 12 months.
• The RL angle increased significantly, approaching the healthy side (from -7.23 to 4.37 degrees).
• Radiographic parameters approached those of the healthy contralateral wrist postoperatively.

Conclusions:

• Arthroscopic dorsal capsulodesis effectively normalizes radiographic SL and RL angles in chronic SL injuries.
• The technique provides sustained correction of DISI without pinning or extensive ligament repair.
• This procedure is a viable option for reducible SL injuries, including those with DISI.