L’instabilità scafo-lunata

Autor: M. Rampoldi, D. Palombi
Rok vydání: 2010
Předmět:
Zdroj: LO SCALPELLO-OTODI Educational. 24:26-34
ISSN: 1970-6812
0390-5276
DOI: 10.1007/s11639-010-0055-5
Popis: Scapholunate instability is the most common carpal instability and accounts for a considerable degree of wrist disfunction. The normal kinematics of the scapholunate joint is governed by a primary stabilizer, the scapholunate (S-L) ligament, and by an envelope of surrounding extrinsic ligaments that act as secondary stabilizers. Injury of the S-L ligament is the first step of a progressive carpal destabilization around the lunate, that can be classified in different stages and that evolves, if untreated, to degenerative changes and carpal collapse. Diagnosis is difficult in the first stages of instability and mostly based on careful clinical examination as standard radiographs may be negative. Arthroscopy should be considered the gold standard in the diagnosis of early stages. Treatment should be tailored to the stage of injury and should aim to restore normal kinematics and arrest progression of disease. Several factors have to be considered in the choice of treatment: degree of the S-L ligament tear, its healing potential, malalignement and its reducibility, cartilage status. Surgical options include primary repair, stabilization with percutaneous pinning, dorsal capsulodesis, partial fusions, tendon weaves and others. When diagnosed, early primary repair of the S-L ligament, if possible, should always be attempted; satisfactory results can be expected by this method. Otherwise, treatment of these complex lesions is not always predictable and seldom entirely satisfactory. Early diagnosis and immediate treatment seem strongly correlated to better outcome.
Databáze: OpenAIRE
Externí odkaz: