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Updated: Jun 13, 2025

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A Biomechanical Comparison of Three Current Scapholunate Reconstruction Methods.

Nicholas I Pilla1, Zachary A Koroneos1, Mark L Dunleavy1

  • 1Department of Orthopaedics and Rehabilitation, Penn State College of Medicine and Milton S. Hershey Medical Center, Hershey, PA.

Journal of Hand Surgery Global Online
|June 11, 2025
PubMed
Summary

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Ultrasonic Anchor-Assisted Restoration of the Scapholunate Ligament Complex: A Cadaveric Study.

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Extensor Retinaculum Capsulorrhaphy and Suture Repair for Ulnocarpal and Distal Radioulnar Joint Instability: One-Year Results.

Journal of hand surgery global online·2025

Scapholunate ligament reconstruction techniques were biomechanically compared. Interosseous reconstruction (IB) and Reduction/Association of the Scaphoid, Lunate (RASL) demonstrated superior durability over Modified Brunelli tenodesis (MBT) in cadaveric models.

Area of Science:

  • Orthopedic surgery
  • Biomechanics
  • Hand surgery

Background:

  • Scapholunate (SL) ligament disruption causes carpal instability and arthritis.
  • No consensus exists on optimal reconstruction for irreparable SL dissociation.

Purpose of the Study:

  • Compare biomechanical stability of three SL reconstruction techniques.
  • Evaluate Modified Brunelli tenodesis (MBT), Reduction/Association of the Scaphoid, Lunate (RASL), and interosseous reconstruction with suture-tape augmentation (IB).

Main Methods:

  • Cadaveric model with 18 upper extremities.
  • Transection of SL stabilizers followed by randomization to MBT, RASL, or IB.
  • Cyclic loading and assessment of SL interval using radiographic, digitizer, and caliper measurements.
Keywords:
Carpal instabilityModified Brunelli tenodesisRASLScapholunate ligament reconstructionSuture-tape augmentation

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Main Results:

  • No significant radiographic SL interval differences initially.
  • MBT showed increased SL angle and widening, with two failures.
  • RASL and IB demonstrated greater durability than MBT under cyclic loading.

Conclusions:

  • IB and RASL offer potentially more durable SL stability than MBT.
  • Adjunct measurement methods (caliper, digitizer) are crucial for assessing carpal instability.
  • Radiographic evaluation alone may underestimate instability.