橈骨手根関節靭帯修復および再建のための背側一時的ステープル固定術

There is a wide variety of techniques to address scapholunate interosseous ligament injury, including both repair and reconstruction of the ligament. What many of these techniques have in common is the protection of the repair or reconstruction by the use of Kirschner wires (K-wires) temporarily placed across the scapholunate and sometimes scaphocapitate articulations to provide immobilization. There are multiple potential downsides to K-wire utilization, including possible interference with the repair or reconstruction, distraction of the scapholunate articulation as the K-wire is passed, occasional need for multiple passes for proper placement, contribution to stress risers within the bone, and unintentional K-wire complications, including breakage, migration, and infection. We describe the use of a dorsal, partially-inserted nitinol staple at the scapholunate articulation as an improved technique over K-wire use for temporary immobilization of the joint. Utilization of the staple allows for compression of the scapholunate interval, direct visualization during insertion, and the ability to avoid interference with the scapholunate interosseous ligament repair or reconstruction. In addition to a description of our surgical technique, we provide a summary of our experience using this technique in patients and a case illustration.