Early Results of All-Dorsal Arthroscopic Scapholunate Ligamentoplasty

We report early outcomes of all-dorsal arthroscopic scapholunate ligamentoplasty (ADAL) in 12 patients.

Dorsal internal brace and capsulodesis were performed in all patients. In half of the patients, a palmaris gracilis tendon graft was used to reconstruct the dorsal aspect of the scapholunate complex. Patients were evaluated for pain, wrist range of motion, grip strength, clinical scores, and radiological appearance at a mean follow-up of 15.9 months.

We obtained similar results in the technique with and without tendon graft. Visual analog scale (VAS 10) score improved from 6 to 1. Wrist range of motion in Flexion-extension increased from 123 to 144 degrees. Postoperative grip strength was 180% more than preoperative, with a mean Mayo wrist score of 79.5 and quick Disabilities of the Arm, Shoulder and Hand (quickDASH) of 14.9. The radiolunate angle decreased from 29 to 10 degrees, the scapholunate (SL) angle from 83 to 52 degrees, and the scapholunate gap from 6 to 3mm.

ADAL has many advantages compared with other scapholunate ligamentoplasties, including minimal invasiveness, association with internal brace and dorsal capsulodesis, and lower risk of carpal fracture or avascular necrosis. Its short-term results are promising.