Athlani Lionel, Pauchard Nicolas, Dautel Gilles
Department of Hand Surgery, Plastic and Reconstructive Surgery, Centre Chirurgical Emile Gallé CHU de Nancy, Nancy, France.
J Hand Surg Eur Vol. 2018 May;43(4):387-393. doi: 10.1177/1753193417746055. Epub 2017 Dec 4.
We performed a cadaveric study to evaluate radiological performance of a technique for scapholunate intercarpal ligamentoplasty designed for treating reducible scapholunate dissociation. We created scapholunate instability in 12 fresh adult cadaveric forearms by sectioning the dorsal scapholunate interosseous ligament and the dorsal intercarpal ligament. All wrists showed scapholunate diastasis, dorsal intercalated segmental instability and posterior scaphoid subluxation. We performed scapholunate intercarpal ligamentoplasty in six wrists and Garcia-Elias three-ligament tenodesis in another six. Wrists were examined radiographically both after ligament sectioning and after ligamentoplasty to compare static and dynamic scapholunate gaps and scapholunate and capitolunate angles. Improvement was statistically significant in all measurements, reflecting a return to normal values. Posterior scaphoid subluxation was also corrected. There was no significant difference between the two treatment groups. Our findings suggest that ligamentoplasty can restore scapholunate joint stability and normal carpal anatomy.
我们进行了一项尸体研究，以评估一种为治疗可复位性舟月骨间韧带分离而设计的舟月骨间韧带成形术的放射学表现。我们通过切断背侧舟月骨间韧带和背侧腕骨间韧带，在12具新鲜成人尸体前臂上制造舟月骨不稳定。所有手腕均显示舟月骨间隙增宽、背侧插入节段性不稳定和舟骨后脱位。我们对6个手腕进行了舟月骨间韧带成形术，对另外6个手腕进行了加西亚 - 埃利亚斯三韧带固定术。在韧带切断后和韧带成形术后均对手腕进行了放射学检查，以比较静态和动态的舟月骨间隙以及舟月骨和头月骨角度。所有测量指标的改善均具有统计学意义，反映出恢复到正常数值。舟骨后脱位也得到了纠正。两个治疗组之间没有显著差异。我们的研究结果表明，韧带成形术可以恢复舟月关节稳定性和正常腕骨解剖结构。
