Mid-term results of scapholunate suture anchor fixation for treatment of scapholunate dissociation

Backhrounds:Scapholunate dissociation (SLD) is the most common and significantligamentous injury of the wrist. The aim of treatment is restoration of carpalalignment. In current study, mid-term results of suture anchor fixation for restorationof normal scapholunate (SL) alignment have been evaluated.MethodsNine male patients (average age: 34.8 years) with symptomatic dynamic or reduciblestatic SLD underwent scapholunate suture anchor fixation (SLAF) from 2011 to 2016 with average follow-up of 36 months. After dorsal wrist exposure, a 2.8mm sutureanchor was inserted in dorsoproximal lateral articular surface of the lunate bone.The two ends of the sutures were traversed from two divergent canals that weremade in opposing articular surface of scaphoid. The sutures were tied over thetuberosity after restoration of normal SL alignment. Two K-wires supported SL andscaphocapitate (SC) alignment for 8 weeks. Radiographic parameters, wrist rangeof motion and grip strength were measured. Quick-DASH and Modified Mayo WristScore (MMWS) were used as outcome measures.Results: The grip strength and passive motion reached %75 and %88 of other side,respectively. The SL gap was measured as 5.4mm, 2.6mm and 3.4mm in pre-op, afterpin removal and follow-up stress x-rays as well as 51.8 ,81.7 and 65.1 degrees for theSL angle. Average Quick-DASH score corrected from 60 to 25. according to MMWSone, one, five and two patients gained excellent, good, satisfactory and poor results,respectively.Conclusions: SLAF is a simple technique with minimal soft tissue manipulation whichable to correct and maintain carpal alignment with favorable mid-term results, especiallyin dynamic SLD.