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Background: Chronic reducible scapholunate instability (SLI) remains a challenging condition, with multiple surgical options described, often associated with soft tissue disruption and postoperative stiffness. We describe a mini-invasive dorsal capsulodesis technique aimed at restoring carpal alignment while minimizing surgical morbidity, and we report preliminary clinical and radiographic outcomes. Methods: This study includes a retrospective analysis of the first 10 consecutive patients treated with this technique who had a minimum follow-up of 3 years. All patients presented with chronic, reducible scapholunate instability. Clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score. Radiographic evaluation was performed to assess maintenance of scapholunate alignment and progression to degenerative changes. Results: At a mean follow-up of approximately 4 years, patients showed a substantial reduction in pain (mean VAS from 8 preoperatively to 2 postoperatively) and improvement in function (mean QuickDASH from 74.6 to 16.5). Radiographic evaluation demonstrated maintenance of carpal alignment in all cases, with no progression to scapholunate advanced collapse (SLAC) observed. Wrist range of motion improved postoperatively, with extension reaching approximately 80° and flexion 70°, without significant functional limitations. No major complications or reoperations were recorded. Patient satisfaction was high, with 9 patients reporting being extremely satisfied and 1 satisfied. Conclusions: This mini-invasive dorsal capsulodesis appears to be a feasible and tissue-sparing option for selected cases of chronic reducible scapholunate instability. In this preliminary series, the technique was associated with favorable clinical and radiographic outcomes at mid-term follow-up. Further studies with larger cohorts and comparative designs are needed to confirm these findings. Full article

Introduction: The scapholunate interosseus ligament (SLIL) is critical for wrist stability, with injuries causing carpal instability and potential scapholunate advanced collapse (SLAC). This technical note presents a novel ligament-sparing surgical technique for treating SLIL tears ranging from grade 2 to 4 of the Garcia-Elias classification. Materials and Methods: A retrospective study was performed on ten patients treated with this novel technique. The technique involves a dorsal approach to the wrist through a 5–7 cm incision ulnar to Lister’s tubercle. After exposing the scapholunate joint, reduction is performed using Kirschner wires (K-wires) as joysticks, followed by stabilisation with three K-wires through the scapholunate, scapho-capitate, and radio-lunate joints. Two 2.3 mm suture anchors with double sutures are placed where the reduction K-wires were removed. One pair of sutures connects the anchors and any remaining SLIL tissue, while the second pair create a shoelace-like capsulodesis. Post-operative care includes staged K-wire removal at one and two months, with progressive rehabilitation before returning to weight-bearing activities at six months. Results: All patients improved in pain and function. The technique addresses SLIL injuries by restoring both coronal alignment through ligament repair and sagittal alignment via dorsal capsulodesis. The use of suture anchors and direct repair preserves the native tissue while reinforcing the dorsal capsule–scapholunate septum complex, avoiding the need for tendon grafts or extensive bone tunnelling. Conclusions: This ligament-sparing technique offers several advantages, including absence of donor site morbidity, minimal damage to carpal cartilage and vascularity, and preservation of surgical options should revision be necessary. The procedure effectively addresses both components of scapholunate instability while maintaining a relatively straightforward surgical approach. Full article