Minimum 5-Year Outcomes of Dorsal Intercarpal Ligament Capsulodesis With Scapholunate Interosseous Ligament Repair for Subacute and Chronic Static Scapholunate Instability: A Clinical Series of 5 Patients

Hiroki Shibayama; Yuichiro Matsui; Daisuke Kawamura; Daisuke Momma; Takeshi Endo; Norimasa Iwasaki

doi:10.1016/j.jhsg.2022.01.007

Minimum 5-Year Outcomes of Dorsal Intercarpal Ligament Capsulodesis With Scapholunate Interosseous Ligament Repair for Subacute and Chronic Static Scapholunate Instability: A Clinical Series of 5 Patients

J Hand Surg Glob Online. 2022 Feb 17;4(3):162-165. doi: 10.1016/j.jhsg.2022.01.007. eCollection 2022 May.

Authors

Hiroki Shibayama¹, Yuichiro Matsui¹, Daisuke Kawamura¹, Daisuke Momma², Takeshi Endo¹, Norimasa Iwasaki¹

Affiliations

¹ Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
² Center for Sports Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan.

Abstract

Purpose: Treatment of subacute and chronic static scapholunate instability remains challenging. We aimed to determine 5- to 10-year outcomes of dorsal intercarpal ligament capsulodesis with scapholunate interosseous ligament repair for subacute and chronic static scapholunate instability.

Methods: Six patients with subacute and chronic static scapholunate instability underwent dorsal intercarpal ligament capsulodesis with scapholunate interosseous ligament repair between 2011 and 2015, and 5 of them were followed for at least 5 years after surgery. The clinical and radiological results were retrospectively investigated. All patients were male, and the mean age at surgery was 37 years (range, 21-47 years). The mean period from injury to surgery was 26.2 months (range, 2-113 months). The surgical procedure was a modification of a method reported by Szabo et al.

Results: The mean postoperative follow-up period was 8.1 years (range, 5.1-9.5 years). Median Disabilities of the Arm, Shoulder, and Hand and Mayo wrist scores improved from 23.3 to 1.7 and from 55 to 80, respectively, from before surgery to the final follow-up. Although the median flexion angle tended to be smaller, the median extension angle tended to be greater than before surgery. The median percent grip strength increased from 72.3% before surgery to 99.2% at the final follow-up. The median scapholunate gap improved from 4.2 mm before surgery to 2.1 mm at the final follow-up. The median scapholunate angle also improved from 95.7° before surgery to 71.3° at the final follow-up. Osteoarthritic changes were observed in 2 of 5 patients at the final follow-up.

Conclusions: The scapholunate gap in all patients was within the normal range after a mean of 8.1 years of follow-up. Dorsal intercarpal ligament capsulodesis with scapholunate interosseous ligament repair is considered a good alternative for subacute and chronic static scapholunate instability based on these 5- to 10-year outcomes.

Type of study/level of evidence: Therapeutic IV.

Keywords: Dorsal intercarpal ligament capsulodesis; Long-term outcomes; Scapholunate interosseous ligament repair; Subacute and chronic static scapholunate instability.