All-Suture Knotless Suture Anchor Repair of Scapholunate Ligament: The Double-Pulley Repair

Abstract

Symptomatic scapholunate tears are a common traumatic problem in the wrist. This article demonstrates a technique for reducing and stabilizing complete scapholunate tears. The purpose is to provide a detailed description of the technique, highlight potential advantages, and discuss preliminary clinical results.

Fig 1

Posteroanterior, clenched fist posteroanterior, and lateral wrist radiographs of a right wrist.

Fig 2

Fluoroscopic image after arthroscopic-assisted reduction and percutaneous pinning of a scapholunate ligament reduction of a right wrist.

Fig 3

Connection of midcarpal radial and 3/4 portals on a right wrist and subsequent extensor pollicis longus and extensor carpi radialis brevis/extensor carpi radialis longus exposure (2nd compartment).

Fig 4

Suture anchors placed through the dorsal approach through the 3/4 portal arthrotomy performed on a right wrist.

Fig 5

Cadaveric representation of arthroscopic knotless FiberTak (Arthrex) reconstruction of the scapholunate ligament (cadeveric left wrist).

Fig 6

Cadaveric demonstration of the double-pulley knotless suture anchor construct before and after tightening in a left wrist.

Fig 7

Illustrative example of suture passage and suture tail dorsal intercarpal ligament proximalization on a right wrist.