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Arch Hand Microsurg > Volume 21(2); 2016 > Article
Journal of the Korean Society for Surgery of the Hand 2016;21(2):55-62.
Published online June 30, 2016.
DOI: https://doi.org/10.12790/jkssh.2016.21.3.55   
Analysis of the Postoperative Outcomes of the Chronic Scapholunate Ligament Instability Managed by Various Surgical Techniques
Kee Baek Ahn, In Hyeok Rhyou, Kyung Chul Kim, Hyeong Jin Kim, Ji Ho Lee, Seong Cheol Moon
Department of Orthopaedic Surgery, Upper Extremity and Microsurgery Center, Pohang Semyeong Christianity Hospital, Pohang, Korea. osdrrih@gmail.com
Received: 30 March 2016   • Revised: 12 May 2016   • Accepted: 17 May 2016
Abstract
Purpose
To investigate mid-term clinical outcomes of various methods of scapholunate reconstruction for chronic scapholunate instability.

Methods
We retrospectively reviewed 11 patients diagnosed as chronic scapholunate instability, from 2005 to 2013 and followed up for more than one year after surgery. 7 patients were treated with Garcia technique of triple ligament reconstruction, 2, bone-ligamemt-bone repair, and 2, dorsal capsulodesis. Mean age was 42 years (range, 23-61 years). The right side was involved in 6 patients, and the left in 5. The follow-up period averaged 42 months (range, 13-125 months). The postoperative functional outcomes were assessed with Modified Mayo wrist score (MMWS), disability of the arm, shoulder and hand (DASH) score and range of motion. The postoperative radiologic results were analyzed with the change of scapholunate angle and distance.

Results
The mean MMWS score improved from 65 preoperatively to 77 postoperatively (p=0.072). The mean DASH score improved from 29.4 (range, 18.3-43.3) preoperatively to 12.7 (range, 0-38.3) postoperatively (p=0.003). The dorsiflexion increased from 67° to 78°, the volar flexion decreased from 51° to 45°, the supination increased from 69° to 88°, and the pronation increased from 62° to 66°. The SL angle changed from 55° preoperatively to 51° postoperatively, the mean SL distance changed from 3.4 mm preoperatively to 1.7 mm postoperatively.

Conclusion
The chronic scapholunate instability is amenable to various techniques and postoperative functional outcomes improved satisfactory.
 
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