Capsulodesis of the wrist for scapholunate dissociation.

We have had favorable results with our early experience using the Mayo modification of the dorsal intercarpal ligament capsulodesis. Our early experience with this technique has shown improvement in carpal alignment and pain relief with the tradeoff of a mild loss of wrist flexion. These results compare with reported results of the various capsulodesis techniques in evolution. Attention must also be paid as to the stage of dissociation at time of surgery. Dynamic dissociation has been treated with capsulodesis alone, whereas a combination of ligament repair in conjunction with dorsal intercarpal ligament capsulodesis is used to treat both dynamic and static variants. Many other investigators report improvements in scapholunate alignment and improvement in pain relief and function with a loss of wrist flexion as a tradeoff. However, despite technical advances in surgical technique and intraoperative improvement of alignment and gapping, these results may diminish by the 2- to 3-year postoperative period. Scapholunate interosseous injuries remain a challenging problem to even experienced hand and upper extremity surgeons. The Mayo modification of the modified dorsal intercarpal ligament capsulodesis is a technique that may be added to the armamentarium of treatment of this pathologic entity.