Volar Scapholunate Ligament Capsulodesis
Joshua A Gillis, MD, BSc1, Joseph S Khouri, MD, BSc1, Sean R Cantwell, MD1 and Steven L. Moran, MD2, (1)Mayo Clinic, Rochester, MN, (2)Department of Surgery, Division of Plastic Surgery, Mayo Clinic, Rochester, MN
Introduction: Scapholunate Ligament (SLL) injury usually begins volarly and progresses dorsally and isolated volar SLL injuries can lead to persistent pain and disrupted carpal kinematics. We describe our experience with the volar capsulodesis technique to repair isolated volar SLL injuries.
Methods: We performed a retrospective chart review for all patients who underwent a volar SLL reconstruction. Demographic data and pre- and post-operative range of motion and radiographic parameters were collected, including pain on a visual analog scale (VAS). Quick Disability of Arm Shoulder Hand (QuickDASH) and Patient-Related Wrist Evaluation (PRWE) questionnaires were completed.
Results: We had 33 wrists with a mean follow-up of 41.1 months. The majority of repairs were using the long radiolunate (91%) with or without the short radiolunate and a volar or dorsal capsulodesis. Arthroscopically, 23 (70%) of patients had a Geissler 3 tear and 8 (24.2%) were Grade 4. Range of motion and grip strength did not differ pre- versus post-operatively. There we no changes in the pre- and post-operative radiographic parameters, including the scapholunate (SL) gap, SL angle and the radiolunate angle. Pre-operative VAS was 5.5, while post-operatively it was 1.0 with 20 (61%) patients reporting “no pain”. Average post-operative QuickDASH and PWRE were 25.8 and 35.1, respectively. Three patients had a pin site infection, and 2 patients had recurrent diastasis.
Conclusion: In isolated volar SLL tears, volar capsulodesis provides reliable patient pain relief and improvement in patient-related outcomes such as QuickDASH and PRWE.
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