Department for Plastic, Hand and Reconstructive Surgery, University Medical Center Regensburg, Regensburg, Germany.
Department for Plastic, Reconstructive, Aesthetic and Hand Surgery, Medical Center Bayreuth, Bayreuth, Germany.
Arch Orthop Trauma Surg. 2019 Nov;139(11):1641-1647. doi: 10.1007/s00402-019-03248-x. Epub 2019 Aug 12.
Injury to the scapholunate (SL) ligament represents a common trauma of the wrist but is frequently misdiagnosed because of non-specific pain. Established methods for SL reconstruction mainly focus on reducing pain and maintaining the reposition result at the expense of mobility and strength. This study aimed at restoring stability and reducing pain while simultaneously maintaining mobility and strength using the scapholunate axis method (SLAM).
22 patients (19 male and 3 female) aged between 26 and 64 years with an SL ligament lesion underwent SLAM reconstruction. Mean duration between injury and operation was 7.9 ± 5 (1-24) months. Hand functions using DASH, Mayo Wrist Score, range of motion, pain (at rest and weight-bearing) and grip strength were assessed prior and 12 months postoperative. Additionally SL angle was collected pre- and postoperative.
Each of the 22 patients improved significantly postoperative in DASH and Mayo Wrist Score with regard to pain at rest and under weight-bearing. Additionally, grip strength could be improved up to 31% compared to preoperatively. In contrast, range of motion and SL angle and grip strength did not change essentially.
The secondary SL ligament reconstruction technique SLAM shows promising results. Pain was significantly relieved and grip strength was significantly increased. Additionally, DASH and Mayo Wrist Score could be significantly improved. However, SL angle and range of motion could not be improved in every patient and plane.
舟月（SL）韧带损伤是腕部常见的创伤，但由于疼痛不具特异性，常被误诊。现有的 SL 重建方法主要侧重于减轻疼痛和维持复位效果，而牺牲了活动度和力量。本研究旨在通过舟月骨间韧带（SLAM）方法恢复稳定性、减轻疼痛，同时保持活动度和力量。
22 例（男 19 例，女 3 例）年龄 26-64 岁的 SL 韧带损伤患者接受了 SLAM 重建。损伤至手术的平均时间为 7.9±5（1-24）个月。术前和术后 12 个月采用 DASH、Mayo 腕关节评分、活动范围、疼痛（静息和负重）和握力进行手部功能评估。此外，还收集了术前和术后的 SL 角。
22 例患者术后 DASH 和 Mayo 腕关节评分的静息和负重疼痛均显著改善。此外，与术前相比，握力可提高高达 31%。相比之下，活动范围和 SL 角以及握力没有明显变化。
继发性 SL 韧带重建技术 SLAM 结果有希望。疼痛明显缓解，握力明显增加。此外，DASH 和 Mayo 腕关节评分也显著改善。然而，并不是每个患者和平面的 SL 角和活动范围都能得到改善。
