Dorsal Scapholunate Ligament Complex Reconstruction Using Suture Tape-Augmented Autologous Free Tendon Graft for Chronic Scapholunate Dissociation.

Autor:	Park HY; Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea., Chae S; Department Orthopedic Surgery, Daegu Catholic University Hospital, College of Medicine, The Daegu Catholic University of Korea, Daegu, Korea., Lee JY; Department of Orthopaedic Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea., Lee JH; Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea., Kim SH; Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea., Park IJ; Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
Jazyk:	angličtina
Zdroj:	Clinics in orthopedic surgery [Clin Orthop Surg] 2024 Oct; Vol. 16 (5), pp. 790-799. Date of Electronic Publication: 2024 Jun 04.
DOI:	10.4055/cios24032
Abstrakt:	Background: The treatment of chronic scapholunate dissociation (SLD) can be challenging due to several factors such as poor quality of ligament, malalignment of the carpus, limited surgical options, and risk of recurrent instability. Various surgical techniques have been developed, but there is ongoing debate regarding the optimal surgical technique. This study aimed to report the clinical and radiological outcomes after dorsal scapholunate (SL) ligament complex reconstruction using suture tape-augmented autologous tendon graft. Methods: The study included patients with Garcia-Elias stage 3-4 chronic SLD, SL advanced collapse (SLAC) stage 1, and a follow-up period exceeding 1 year. Pre- and postoperative SL gap, SL angle (SLA), radiolunate angle (RLA), and dorsal scaphoid translation (DST) were measured, and wrist active range of motion, Modified Mayo Wrist Score (MMWS), and visual analog scale (VAS) were evaluated. Results: Nine patients were included in this study with a mean follow-up period of 17 months (range, 15-31 months). All patients were male, with a mean age of 49 years (range, 30-62 years). Eight patients were classified as Garcia-Elias stage 4, while one was classified as SLAC 1. The median (range) of preoperative, immediate postoperative, and final follow-up measurements for SL gap, SLA, RLA, and DST were 5.4 mm (4.5-5.9), 2.1 mm (1.8-2.5), and 2.5 mm (2.0-2.8) ( p = 0.008); 76° (69°-88°), 50° (32°-56°), and 54° (50°-64°) ( p = 0.008); 22° (11.5°-33°), 2.8° (0.5°-3.8°), and 3.8° (2.2°-5.6°) ( p = 0.008); and 2.8 mm (2.0-3.4), 0.8 mm (0.1-1.2), and 1.0 mm (0.1-2.0) ( p = 0.008), respectively. Immediately after surgery, all radiological measurements showed significant improvement, which persisted up to 15 months postoperatively. The preoperative and final follow-up measurements of active flexion, extension, radial deviation, and ulnar deviation of the wrist showed significant improvement. The median preoperative and final follow-up values of MMWS were 51.1 (range, 40-60) and 88.3 (range, 85-95) ( p = 0.007), respectively, and those of VAS were 7 (range, 6-8) and 2 (range, 1-3) ( p = 0.007), respectively. Conclusions: Dorsal SL ligament complex reconstruction using suture tape-augmented autologous free tendon graft could be regarded as a feasible and straightforward technique for addressing irreparable chronic SLD. Competing Interests: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. (Copyright © 2024 by The Korean Orthopaedic Association.)
Databáze:	MEDLINE
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