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. 2021 Dec 17;4(2):103-110.
doi: 10.1016/j.jhsg.2021.10.007. eCollection 2022 Mar.

Outcomes of Acute Versus Subacute Scapholunate Ligament Repair

Raymond E Chen  1 , Ryan P Calfee  2 , Jeffrey G Stepan  3 , Daniel A Osei  4
Affiliations

Outcomes of Acute Versus Subacute Scapholunate Ligament Repair

Raymond E Chen et al. J Hand Surg Glob Online. .

Abstract

Purpose: This study investigated the long-term outcomes of direct scapholunate ligament (SLL) repairs with or without dorsal capsulodesis performed within 6 weeks (acute repair) of a SLL tear versus 6 to 12 weeks following injury (subacute repair).

Methods: A review of medical records from April 1996 to April 2012 identified 24 patients who underwent SLL repair (12 acute, 12 subacute). Patients returned to the clinic for radiographic examinations of the injured wrist, standardized physical examinations, and validated questionnaires.

Results: The mean follow-up times for the acute and subacute groups were 7.2 and 6.2 years, respectively. At the final examination, patients with acute surgery regained more wrist extension (acute = 55°, subacute = 47°). The total wrist flexion-extension arcs, grip strengths, pinch strengths, and patient-rated outcome scores were found to be similar between groups. The final scapholunate gap, scapholunate angle, and the prevalence of arthritis were also found to be similar between the acute and subacute groups.

Conclusions: Although SLL repair is more commonly recommended for treatment of acute SLL injuries, there were no significant long-term differences between acute and subacute SLL surgeries (repair ± capsulodesis).

Type of study/level of evidence: Prognostic III.

Keywords: Dorsal capsulodesis; SLL repair; Scapholunate dissociation; Scapholunate ligament; Subacute SLL.

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Figures

Figure 1
Figure 1
A Preoperative posterioanterior and lateral radiographs of a patient with a stage 2 SLL injury. B Preoperative magnetic resonance image demonstrating disruption of the dorsal fibers of the SLL (blue arrows).
Figure 2
Figure 2
Postoperative posterioanterior and lateral radiographs 4.5 years following suture repair through bone tunnels and dorsal capsulodesis.
See this image and copyright information in PMC

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