Reconstruction of chronic scapholunate dissociation with the modified scapholunate axis method (SLAM)

Introduction Injury to the scapholunate (SL) ligament represents a common trauma of the wrist but is frequently misdiagnosed because of non-specific pain. Established methods for SL reconstruction mainly focus on reducing pain and maintaining the reposition result at the expense of mobility and stre...

Full description

Saved in:
Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2019-11, Vol.139 (11), p.1641-1647
Main Authors: Dolderer, Juergen H., Zimny, Katja, Klein, Silvan M., Koller, Michael, Prantl, Lukas, Geis, Sebastian
Format: Article
Language:English
Subjects:
Adult
Exercise
Female
Handsurgery
Humans
Injuries
Joint Instability - surgery
Ligaments
Male
Medicine
Medicine & Public Health
Methods
Middle Aged
Orthopedic Procedures - methods
Orthopedics
Pain
Patients
Range of Motion, Articular - physiology
Reconstructive Surgical Procedures - methods
Scaphoid Bone - surgery
Surgery
Surgical techniques
Trauma
Wrist Injuries - surgery
Wrist Joint - surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction Injury to the scapholunate (SL) ligament represents a common trauma of the wrist but is frequently misdiagnosed because of non-specific pain. Established methods for SL reconstruction mainly focus on reducing pain and maintaining the reposition result at the expense of mobility and strength. This study aimed at restoring stability and reducing pain while simultaneously maintaining mobility and strength using the scapholunate axis method (SLAM). Material and methods 22 patients (19 male and 3 female) aged between 26 and 64 years with an SL ligament lesion underwent SLAM reconstruction. Mean duration between injury and operation was 7.9 ± 5 (1–24) months. Hand functions using DASH, Mayo Wrist Score, range of motion, pain (at rest and weight-bearing) and grip strength were assessed prior and 12 months postoperative. Additionally SL angle was collected pre- and postoperative. Results Each of the 22 patients improved significantly postoperative in DASH and Mayo Wrist Score with regard to pain at rest and under weight-bearing. Additionally, grip strength could be improved up to 31% compared to preoperatively. In contrast, range of motion and SL angle and grip strength did not change essentially. Conclusions The secondary SL ligament reconstruction technique SLAM shows promising results. Pain was significantly relieved and grip strength was significantly increased. Additionally, DASH and Mayo Wrist Score could be significantly improved. However, SL angle and range of motion could not be improved in every patient and plane.
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-019-03248-x