Document Detail


Long-term results of dorsal intercarpal ligament capsulodesis for the treatment of chronic scapholunate instability.
MedLine Citation:
PMID:  23188908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to assess the clinical and radiological outcomes of dorsal intercarpal ligament capsulodesis for the treatment of static scapholunate instability at a minimum follow-up of four years. A total of 59 patients who underwent capsulodesis for this condition were included in a retrospective analysis after a mean of 8.25 years (4.3 to 12). A total of eight patients underwent a salvage procedure at a mean of 2.33 years (0.67 to 7.6) and were excluded. The mean range of extension/flexion was 88° (15° to 135°) and of ulnar/radial deviation was 38° (0° to 75°) at final follow-up. The mean Disabilities of the Arm Shoulder and Hand (DASH) score and Mayo wrist scores were 28 (0 to 85) and 61 (0 to 90), respectively. After significant improvement immediately post-operatively (p < 0.001 and p = 0.001, respectively), the mean scapholunate and radiolunate angles deteriorated to 70° (40° to 90°) and 8° (-15° to 25°), respectively, at final follow-up, which were not significantly different from their pre-operative values (p = 0.6 and p = 0.4, respectively). The mean carpal height index decreased significantly from 1.53 (1.38 to 1.65) to 1.48 (1.29 to 1.65) indicating progressive carpal collapse (p < 0.001); 40 patients (78%) had radiological evidence of degenerative arthritis. Capsulodesis did not maintain carpal reduction over time. Although the consequent ongoing scapholunate instability resulted in early arthritic degeneration, most patients had acceptable long-term function of the wrist.
Authors:
K Megerle; D Bertel; G Germann; M Lehnhardt; S Hellmich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  94     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-28     Completed Date:  2013-04-04     Revised Date:  2013-11-14    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  1660-5     Citation Subset:  AIM; IM    
Affiliation:
Clinic for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany. kai.megerle@mri.tum.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Carpal Bones / radiography,  surgery*
Chronic Disease
Female
Follow-Up Studies
Humans
Joint Capsule / radiography,  surgery*
Joint Instability / surgery*
Ligaments, Articular / surgery*
Lunate Bone / radiography,  surgery*
Male
Middle Aged
Questionnaires
Range of Motion, Articular
Retrospective Studies
Scaphoid Bone / radiography,  surgery*
Treatment Outcome
Wrist Joint / radiography,  surgery*
Young Adult
Comments/Corrections
Comment In:
Unfallchirurg. 2013 Oct;116(10):868-9

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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