Long-term outcomes of dorsal intercarpal ligament capsulodesis for chronic scapholunate dissociation

Varun K Gajendran, Brett Peterson, Robert R Slater, Robert M Szabo
Journal of Hand Surgery 2007, 32 (9): 1323-33

PURPOSE: Chronic scapholunate dissociation is the most common cause of symptomatic wrist instability. In an attempt to restore normal carpal mechanics and prevent wrist arthrosis, we developed and tested biomechanically the dorsal intercarpal ligament capsulodesis (DILC). Previously, we reported good early clinical results for this procedure at an average follow-up period of 25 months. Here, we report on the functional and radiographic outcomes at a longer follow-up period of a minimum of 5 years.

METHODS: Records of patients undergoing the DILC for chronic (greater than 6 weeks), flexible, static scapholunate dissociation were reviewed. Only patients with follow-up evaluation of greater than 60 months were included. Physical examination, radiographs, and validated outcome instruments were used to evaluate the patients.

RESULTS: Twenty-one patients (22 wrists) met the inclusion criteria. Fifteen of 21 patients (16 wrists) were available for follow-up evaluation. Average follow-up period was 86 months. Physical examination revealed average wrist flexion and extension of 50 degrees and 55 degrees , respectively, radial and ulnar deviation of 17 degrees and 36 degrees , respectively, and grip strength of 43 kgf. Disabilities of the Arm, Shoulder and Hand, Short Form-12, and Mayo wrist scores averaged 19, 78, and 78, respectively. Radiographs revealed an average scapholunate angle and gap of 62 degrees and 3.5 mm, respectively. Eight of the 16 wrists in our study demonstrated arthritic changes on radiographs.

CONCLUSIONS: The DILC does not consistently prevent radiographic deterioration and the development of arthrosis in the long-term; however, the level of functionality and patient satisfaction remained relatively high in 58% of our patients, suggesting a lack of correlation between the radiographic findings and development of arthrosis and the functional outcomes and patient satisfaction. We believe that the DILC is still a reasonable option for treating flexible static scapholunate dissociation in patients without radiographic signs of arthritis presenting with wrist pain despite conservative treatment. Prevention of radiographic deterioration and arthrosis remains an unsolved problem.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.