Anatomical anterior and posterior reconstruction for scapholunate dissociation: preliminary outcome in ten patients

Abstract

This study reviews the efficacy of a reconstruction to address scapholunate dissociation using an anterior and posterior approach with a hybrid synthetic tape/tendon weave between the trapezium, scaphoid, lunate and radius: an anatomical front and back (ANAFAB) repair. This repair is a compilation of the components of a number of previously reported repair techniques, and based on published kinematic evidence. It aims to restore the anatomical mechanical constraints on both anterior and posterior aspects of the carpus. Patients were immobilized in a cast for 6 weeks, but no stabilizing wires were used. Ten patients have undergone the reconstruction and were assessed at a minimum 24-month follow-up. They achieved excellent realignment of the carpus, a postoperative median scapholunate gap of 3 mm and a recovery of more than 75% of grip strength and range of motion. No patient required secondary surgery or treatment related to the carpal stabilization. Level of evidence: IV.

Keywords: ANAFAB; carpal instability; scapho-lunate dissociation.