Review of surgical treatment for chronic scapholunate ligament reconstruction: a long-term study.

PURPOSE: Scapholunate dissociation (SLD) is a common entity encountered by hand surgeons. While multiple methods for surgical treatment exist, there is little agreement on the best surgical techniques to treat chronic, static SLD. Our study's goal was to assess the long-term (greater than five years), clinical and radiologic outcomes of the currently recommended treatment options for chronic, static SLD.

METHODS

We performed a review of the literature to assess outcomes after surgical treatment of chronic, static SLD with long-term follow-up of greater than five years.

RESULTS

We found only six studies that encompassed the modified Brunelli tenodesis, capsulodesis, scapholunate arthrodesis, and bone-ligament-bone graft using the modified Cuenod procedure. All were level of evidence IV. Many patients went back to some form of work. Tenodesis showed less development of arthritis and greater improvement in scapholunate gap, while capsulodesis showed greater postoperative flexion and extension. Of note, study size varied with 67 combined patients in the capsulodesis studies and 30 patients in the tenodesis studies.

CONCLUSION

There was no clear superiority of one procedure over the others. More long-term data are needed to identify the best surgical treatment of chronic, static SLD.