Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 14:23:e33.
eCollection 2023.

Comparison of Treatment Options for Chronic Scapholunate Interosseous Ligament (SLIL): A Systematic Literature Review and Meta-Analysis

Kamil M Amer  1 , Jennifer E Thomson  1 , Samer T Elsamna  1 , Dominick V Congiusta  1 , Owen Gantz  1 , Robert L DalCortivo  1 , Michael M Vosbikian  1 , Irfan H Ahmed  1
Affiliations

Comparison of Treatment Options for Chronic Scapholunate Interosseous Ligament (SLIL): A Systematic Literature Review and Meta-Analysis

Kamil M Amer et al. Eplasty. .

Abstract

Background: The scapholunate interosseous ligament (SLIL) is an important contributor to wrist stability and functionality. SLIL injury is debilitating and therefore many surgical techniques have been proposed, but the optimal treatment modality remains debated.This meta-analysis reviews the available literature comparing surgical techniques used in the treatment of chronic SLIL to determine the best approach.

Methods: An electronic search of the literature was conducted to identify all randomized controlled trials and cohort studies published before January 2019 that evaluated clinical outcomes of capsulodesis reconstruction, the modified Brunelli technique, and the reduction and association of the scaphoid and lunate (RASL) procedure for treatment of chronic SLIL. A chi-square analysis was performed to identify possible differences between each technique for several outcome measures.

Results: A total 20 studies encompassing 409 patients met inclusion criteria. Average age among patients was 36.7 years, and 68.2% of patients were male. Reductions in visual analog scale pain scale; Disabilities of Arm, Shoulder, and Hand (DASH) scores; and increases in grip strength and range of motion were observed for all techniques. Capsulodesis was superior to the modified Brunelli technique regarding preserved range of motion.

Conclusions: No significant differences were observed among any of the techniques for pain, DASH score, and grip strength outcomes. Capsulodesis, modified Brunelli, and RASL surgical techniques for the treatment of chronic SLIL injuries may all be seen as reliable methods of treatment of chronic SLIL injuries. While future trials directly comparing these methods are needed, this study suggests there is no superiority of one technique over another.

Keywords: Clinical; Hand; Ligament; Outcomes; Scapholunate; Wrist.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Literature review flow chart.
Figure 2
Figure 2
Pain forest plot.
Figure 3
Figure 3
Grip strength forest plot.
Figure 4
Figure 4
DASH score forest plot.
Figure 5
Figure 5
Arc of motion forest plot.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mathoulin C, Dauphin N, Wahegaonkar A. Arthroscopic dorsal capsuloligamentous repair in chronic scapholunate ligament tears. Hand Clin. 2011;27(4):563-572, xi. doi:10.1016/j.hcl.2011.07.00310.1016/j.hcl.2011.07.003 - DOI - DOI - PubMed
    1. Zarkadas P, White N, Bertrand P. A survey of the surgical management of acute and chronic scapholunate instability. J Hand Surg. 2004; 29A(5):848-857. doi:10.1016/j.jhsa.2004.05.00810.1016/j.jhsa.2004.05.008 - DOI - DOI - PubMed
    1. Mathoulin C. Treatment of dynamic scapholunate instability dissociation: contribution of arthroscopy. Hand Surg Rehabil. 2016;35(6):377-392. doi:10.1016/j.hansur.2016.09.00210.1016/j.hansur.2016.09.002 - DOI - DOI - PubMed
    1. Manuel J, Moran S. The diagnosis and treatment of scapholunate instability. Hand Clin. 2010;26(1):129-144. doi:10.1016/j.hcl.2009.08.00610.1016/j.hcl.2009.08.006 - DOI - DOI - PubMed
    1. Alonso Rasgado T, Zhang Q, Jimenez Cruz D, et al. . Analysis of tenodesis techniques for treatment of scapholunate instability using the finite element method. Int J Numer Method Biomed Eng. 2017;33(12):e2897. doi:10.1002/cnm.289710.1002/cnm.2897 - DOI - DOI - PubMed

LinkOut - more resources