Search Results (3)

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

Background/Objectives: This study aimed to investigate the results of surgical intervention in cases of scaphoid nonunion and delayed healing among individuals aged 18 or younger, focusing on both clinical and radiological aspects, as well as identifying possible factors that may impact the effectiveness or failure of the treatment. Methods: A total of 20 boys with impaired scaphoid bone healing underwent surgical treatment, with the average duration between the suspected injury and the procedure being approximately 10.8 months. At the time of surgery, the patients had a mean age of 15 years, and the average follow-up period was 20 months. We assessed the type of surgery performed, along with range of motion and pain intensity, comparing preoperative findings with those recorded at the final evaluation. Based on lateral X-ray examination, CLA (capitolunate angle), SCA (scaphocapitate angle), and SLA (scapholunate angle) angles were measured before and after surgery and at the last follow-up. Results: The treatment results showed bone union in 18 out of 20 patients (90%), complete pain relief in 17 patients (85%), and a significant improvement in ROM. There was a statistically significant improvement in the SLA angle and an increase in wrist dorsal flexion. We also identified three factors that significantly influence better ROM after surgery, namely the values of the CLA and SLA angles, as well as the time from injury to surgery. Conclusions: Our findings suggest that surgical intervention contributes to improved joint mobility, pain reduction, and restoration of anatomical alignment in the wrist. While we identified factors associated with more favorable functional results, we did not find any that were linked to a higher likelihood of treatment failure. Full article

Introduction: The scapholunate interosseous ligament is pivotal for wrist stability, and its impairment can result in instability and joint degeneration. This study explores the application of real-time MRI for dynamic assessment of the scapholunate joint during wrist motion with the objective of determining its diagnostic value in efficacy in contrast to static imaging modalities. Materials and Methods: Ten healthy participants underwent real-time MRI scans during wrist ab/adduction and fist-clenching maneuvers. Measurements were obtained at proximal, medial, and distal landmarks on both dynamic and static images with statistical analyses conducted to evaluate the reliability of measurements at each landmark and the concordance between dynamic measurements and established static images. Additionally, inter- and intraobserver variabilities were evaluated. Results: Measurements of the medial landmarks demonstrated the closest agreement with static images and exhibited the least scatter. Distal landmark measurements showed a similar level of agreement but with increased scatter. Proximal landmark measurements displayed substantial deviation, which was accompanied by an even greater degree of scatter. Although no significant differences were observed between the ab/adduction and fist-clenching maneuvers, both inter- and intraobserver variabilities were significant across all measurements. Conclusions: This study highlights the potential of real-time MRI in the dynamic assessment of the scapholunate joint particularly at the medial landmark. Despite promising results, challenges such as measurement variability need to be addressed. Standardization and integration with advanced image processing methods could significantly enhance the accuracy and reliability of real-time MRI, paving the way for its clinical implementation in dynamic wrist imaging studies. Full article