Open reduction and internal fixation of scapholunate ligament injuries

Scapholunate dissociation is the most common cause of carpal instability. When patients demonstrate gross instability, open repair of the scapholunate interval with repair of the DIC and DRC ligaments can provide pain relief and good functional outcomes. This repair yields the best result when performed within 3 months of injury and before the development of degenerative changes. Radiographic results deteriorate over time and do not correlate with patients' subjective outcomes. It is thought that surgical reconstruction of the SLIL and dorsal ligaments will prevent progression to SLAC wrist. Further studies - ideally a randomized, prospective trial comparing operative intervention with the natural course of scapholunate dissociation - will need to be undertaken to conclude whether or not operative repair of the scapholunate ligament and dorsal ligaments prevents the SLAC wrist.

Duke Scholars

Author David Simms Ruch Orthopaedic Surgery