Arthroscopic dorsal capsuloplasty as treatment for chronic scapholunate tear
Epublication WebSurg.com, Nov 2010;10(11). URL: http://websurg.com/doi/vd01en3038
The sprain of the scapholunate ligament generates chronic instability, which leads to a chondral change with carpus arthritis. The use of wrist arthroscopy allows the diagnosis of these lesions, even at an early stage, and, sometimes, provides a therapeutic strategy by performing a stable fixation. In some chronic cases when the ligament cannot be repaired but the scapholunate space is reducible (stage 2 to 4 according to Garcia-Elias’ classification), a new arthroscopic dorsal capsuloplasty has been performed in order to avoid a complex reconstruction with common stiffness. The patients were operated on in outpatient settings under regional anesthesia using a pneumatic tourniquet. The capsuloplasty is arthroscopically performed between the dorsal capsule and the dorsal part of the scapholunate ligament, using a PDS suture loop. Scapholunate and scaphocapitate Kirschner wires are placed only at stage 4 after scaphoid reduction. A volar splint was placed for a period of 2 months.