Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-11-2019 | Handsurgery

Reconstruction of chronic scapholunate dissociation with the modified scapholunate axis method (SLAM)

Authors: Juergen H. Dolderer, Katja Zimny, Silvan M. Klein, Michael Koller, Lukas Prantl, Sebastian Geis

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 11/2019

Abstract

Introduction

Injury to the scapholunate (SL) ligament represents a common trauma of the wrist but is frequently misdiagnosed because of non-specific pain. Established methods for SL reconstruction mainly focus on reducing pain and maintaining the reposition result at the expense of mobility and strength. This study aimed at restoring stability and reducing pain while simultaneously maintaining mobility and strength using the scapholunate axis method (SLAM).

Material and methods

22 patients (19 male and 3 female) aged between 26 and 64 years with an SL ligament lesion underwent SLAM reconstruction. Mean duration between injury and operation was 7.9 ± 5 (1–24) months. Hand functions using DASH, Mayo Wrist Score, range of motion, pain (at rest and weight-bearing) and grip strength were assessed prior and 12 months postoperative. Additionally SL angle was collected pre- and postoperative.

Results

Each of the 22 patients improved significantly postoperative in DASH and Mayo Wrist Score with regard to pain at rest and under weight-bearing. Additionally, grip strength could be improved up to 31% compared to preoperatively. In contrast, range of motion and SL angle and grip strength did not change essentially.

Conclusions

The secondary SL ligament reconstruction technique SLAM shows promising results. Pain was significantly relieved and grip strength was significantly increased. Additionally, DASH and Mayo Wrist Score could be significantly improved. However, SL angle and range of motion could not be improved in every patient and plane.

Engelhardt TO, Krimmer H (2006) Dissoziative Instabilitäten der proximalen Handwurzelreihe. In: Krupp, Rennekampff (eds) Plastische Chirurgie. pp 1–22

Lameijer CM, Ten Duis HJ, Vroling D, Hartlief MT, El Moumni M, van der Sluis CK (2018) Prevalence of posttraumatic arthritis following distal radius fractures in non-osteoporotic patients and the association with radiological measurements, clinician and patient-reported outcomes. Arch Orthop Trauma Surg 138(12):1699–1712. https://doi.org/10.1007/s00402-018-3046-2 CrossRefPubMedPubMedCentral

Gradl G, Pillukat T, Fuchsberger T, Knobe M, Ring D, Prommersberger KJ (2013) The functional outcome of acute scapholunate ligament repair in patients with intraarticular distal radius fractures treated by internal fixation. Arch Orthop Trauma Surg 133(9):1281–1287. https://doi.org/10.1007/s00402-013-1797-3 CrossRefPubMed

Quadlbauer S, Pezzei C, Jurkowitsch J, Rosenauer R, Pichler A, Schattin S, Hausner T, Leixnering M (2018) Early complications and radiological outcome after distal radius fractures stabilized by volar angular stable locking plate. Arch Orthop Trauma Surg 138(12):1773–1782. https://doi.org/10.1007/s00402-018-3051-5 CrossRefPubMed

Schnetzke M, Fuchs J, Vetter SY, Swartman B, Keil H, Grutzner PA, Franke J (2018) Intraoperative three-dimensional imaging in the treatment of distal radius fractures. Arch Orthop Trauma Surg 138(4):487–493. https://doi.org/10.1007/s00402-018-2867-3 CrossRefPubMed

Gologan R, Ginter VM, Haeffner A, Obertacke U, Schreiner U (2016) 1-Year outcome of concomitant intracarpal lesions in patients with dislocated distal radial fractures: a systematic assessment of 78 distal radial fractures. Arch Orthop Trauma Surg 136(3):425–432. https://doi.org/10.1007/s00402-015-2357-9 CrossRefPubMed

Gologan RE, Koeck M, Suda AJ, Obertacke U (2019) %3e 10-year outcome of dislocated radial fractures with concomitant intracarpal lesions as proven by MRI and CT. Arch Orthop Trauma Surg 139(6):877–881. https://doi.org/10.1007/s00402-019-03186-8 CrossRefPubMed

Garcia-Elias M, Alomar Serrallach X, Monill Serra J (2014) Dart-throwing motion in patients with scapholunate instability: a dynamic four-dimensional computed tomography study. J Hand Surg Eur 39(4):346–352. https://doi.org/10.1177/1753193413484630 CrossRef

Moritomo H, Apergis EP, Garcia-Elias M, Werner FW, Wolfe SW (2014) International Federation of Societies for Surgery of the Hand 2013 Committee's report on wrist dart-throwing motion. J Hand Surg Am 39(7):1433–1439. https://doi.org/10.1016/j.jhsa.2014.02.035 CrossRefPubMed

10.

Prommersberger KJ, Muhldorfer-Fodor M, Kalb K, Schmitt R, van Schoonhoven J (2014) Scapholunate lesions. Unfallchirurg 117(8):723–737. https://doi.org/10.1007/s00113-014-2621-4 (quiz 729–738) CrossRefPubMed

11.

Gabl M, Arora R, Klauser AS, Schmidle G (2016) Characteristics of secondary arthrofibrosis after intra-articular distal radius fracture. Arch Orthop Trauma Surg 136(8):1181–1188. https://doi.org/10.1007/s00402-016-2490-0 CrossRefPubMed

12.

Quadlbauer S, Leixnering M, Jurkowitsch J, Hausner T, Pezzei C (2017) Volar radioscapholunate arthrodesis and distal scaphoidectomy after malunited distal radius fractures. J Hand Surg Am 42(9):754.e1–754.e8. https://doi.org/10.1016/j.jhsa.2017.05.031 CrossRef

13.

Busse F, Felderhoff J, Krimmer H, Lanz U (2002) Scapholunate dissociation: treatment by dorsal capsulodesis. Handchir Mikrochir Plast Chir 34(3):173–181. https://doi.org/10.1055/s-2002-33690 CrossRefPubMed

14.

Pappou IP, Basel J, Deal DN (2013) Scapholunate ligament injuries: a review of current concepts. Hand (N Y) 8(2):146–156. https://doi.org/10.1007/s11552-013-9499-4 CrossRef

15.

Harvey EJ, Berger RA, Osterman AL, Fernandez DL, Weiss AP (2007) Bone-tissue-bone repairs for scapholunate dissociation. J Hand Surg Am 32(2):256–264. https://doi.org/10.1016/j.jhsa.2006.11.011 CrossRefPubMed

16.

Brunelli GA, Brunelli GR (1995) A new technique to correct carpal instability with scaphoid rotary subluxation: a preliminary report. J Hand Surg Am 20(3 Pt 2):S82–85CrossRef

17.

Garcia-Elias M, Lluch AL, Stanley JK (2006) Three-ligament tenodesis for the treatment of scapholunate dissociation: indications and surgical technique. J Hand Surg Am 31(1):125–134. https://doi.org/10.1016/j.jhsa.2005.10.011 CrossRefPubMed

18.

Van Den Abbeele KL, Loh YC, Stanley JK, Trail IA (1998) Early results of a modified Brunelli procedure for scapholunate instability. J Hand Surg Br 23(2):258–261CrossRef

19.

Meier R, Prommersberger KJ, Krimmer H (2003) Scapho-trapezio-trapezoid arthrodesis (triscaphe arthrodesis). Handchir Mikrochir Plast Chir 35(5):323–327. https://doi.org/10.1055/s-2003-43111 CrossRefPubMed

20.

Hernekamp JF, Kneser U, Kremer T, Bickert B (2017) Midcarpal partial arthrodesis with locking plate osteosynthesis. Oper Orthop Traumatol 29(5):409–415. https://doi.org/10.1007/s00064-017-0514-8 CrossRefPubMed

21.

Spies C, Unglaub F (2017) (Partial) arthrodesis of the hand and wrist. Oper Orthop Traumatol 29(5):373. https://doi.org/10.1007/s00064-017-0518-4 CrossRefPubMed

22.

Yao J, Zlotolow DA, Lee SK (2016) ScaphoLunate axis method. J Wrist Surg 5(1):59–66. https://doi.org/10.1055/s-0035-1570744 CrossRefPubMedPubMedCentral

23.

Lee SK, Zlotolow DA, Sapienza A, Karia R, Yao J (2014) Biomechanical comparison of 3 methods of scapholunate ligament reconstruction. J Hand Surg Am 39(4):643–650. https://doi.org/10.1016/j.jhsa.2013.12.033 CrossRefPubMed

24.

Dolderer JH, Zimny K, Klein S, Koller M, Prantl L, Geis S (2019) Modified SLAM (scapholunate axis method) technique for secondary SL reconstruction: preliminary results. Handchir Mikrochir Plast Chir 51(1):32–37. https://doi.org/10.1055/a-0839-4926 CrossRefPubMed

25.

Meszaros T, Vogelin E, Mathys L, Leclere FM (2018) Perilunate fracture-dislocations: clinical and radiological results of 21 cases. Arch Orthop Trauma Surg 138(2):287–297. https://doi.org/10.1007/s00402-017-2861-1 CrossRefPubMed

26.

Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G (2014) Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (QuickDASH). J Orthop Sports Phys Ther 44(1):30–39. https://doi.org/10.2519/jospt.2014.4893 CrossRefPubMed

27.

Gajendran VK, Peterson B, Slater RR Jr, Szabo RM (2007) Long-term outcomes of dorsal intercarpal ligament capsulodesis for chronic scapholunate dissociation. J Hand Surg Am 32(9):1323–1333. https://doi.org/10.1016/j.jhsa.2007.07.016 CrossRefPubMed

28.

Moran SL, Cooney WP, Berger RA, Strickland J (2005) Capsulodesis for the treatment of chronic scapholunate instability. J Hand Surg Am 30(1):16–23. https://doi.org/10.1016/j.jhsa.2004.07.021 CrossRefPubMed

29.

Wyrick JD, Youse BD, Kiefhaber TR (1998) Scapholunate ligament repair and capsulodesis for the treatment of static scapholunate dissociation. J Hand Surg Br 23(6):776–780CrossRef

30.

Svoboda SJ, Eglseder WA Jr, Belkoff SM (1995) Autografts from the foot for reconstruction of the scapholunate interosseous ligament. J Hand Surg Am 20(6):980–985. https://doi.org/10.1016/S0363-5023(05)80146-7 CrossRefPubMed

31.

Kleinman WB, Ct Carroll (1990) Scapho-trapezio-trapezoid arthrodesis for treatment of chronic static and dynamic scapho-lunate instability: a 10-year perspective on pitfalls and complications. J Hand Surg Am 15(3):408–414CrossRef

32.

van Kampen RJ, Bayne CO, Moran SL, Berger RA (2015) Outcomes of capitohamate bone-ligament-bone grafts for scapholunate injury. J Wrist Surg 4(4):230–238. https://doi.org/10.1055/s-0035-1556866 CrossRefPubMedPubMedCentral

Title: Reconstruction of chronic scapholunate dissociation with the modified scapholunate axis method (SLAM)
Authors: Juergen H. Dolderer
Katja Zimny
Silvan M. Klein
Michael Koller
Lukas Prantl
Sebastian Geis
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 11/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-019-03248-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Reconstruction of chronic scapholunate dissociation with the modified scapholunate axis method (SLAM)

Abstract

Introduction

Material and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Material and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2019

The PRECICE magnetic IM compression nail for long bone nonunions: a preliminary report

Prospective randomized comparison of early versus newer-generation vertebral access devices for kyphoplasty

Reduced wound leakage in arthroplasty with modified wound closure: a retrospective cohort study

Radiographic assessment of overlengthening of the MoPyC radial head prosthesis: a cadaveric study

Intraoperative measurement of cup inclination using fluoroscopy requires a correction factor

Post-carbon-ion radiotherapy vertebral pathological fractures in upper cervical primary malignant spinal tumors treated by occipito-cervical fusion