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[Scapholunate dissociation].

D Buck-Gramcko

    Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
    |July 1, 1985
    PubMed
    Summary
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    Scapholunate dissociation involves ligament rupture, causing wrist instability and a characteristic "concertina" deformity. Surgical repair or reconstruction aims to restore carpal stability, though outcomes vary.

    Area of Science:

    • Orthopedic Surgery
    • Hand Surgery
    • Biomechanics

    Background:

    • Scapholunate dissociation is a common wrist injury resulting from ligamentous rupture.
    • This condition leads to rotatory subluxation of the scaphoid and widening of the scapholunate gap.
    • It disrupts the carpal 'link system', causing dorsal instability and a 'concertina' deformity.

    Purpose of the Study:

    • To review the pathophysiology and treatment options for scapholunate dissociation.
    • To compare primary ligament repair, ligament reconstruction, and scapho-trapezio-trapezoid arthrodesis.
    • To evaluate the functional and radiological outcomes of different treatment modalities.

    Main Methods:

    • Review of literature on scapholunate dissociation.
    • Analysis of surgical techniques including primary ligament repair, tendon graft reconstruction, and arthrodesis.

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  • Assessment of radiological parameters like the scapholunate angle and clinical outcomes.

    • Main Results:

    • Primary repair is ideal but often not feasible due to late presentation.
    • Ligament reconstruction can yield unsatisfactory radiological results but may offer minimal patient disability.
    • Scapho-trapezio-trapezoid arthrodesis offers an alternative by restoring carpal stability.

    Conclusions:

    • Scapholunate dissociation requires prompt treatment to restore carpal mechanics.
    • While ligament reconstruction has limitations, arthrodesis presents a viable alternative for restoring carpal stability.
    • Further research is needed to optimize surgical outcomes for this complex wrist injury.