The authors retrospectively reviewed 10 patients with wrist pain attributed to structural disruption of the scapholunate interosseous ligament (Geissler, Type 2 injuries) who were treated with wrist arthroscopy and electrothermal collagen shrinkage of the scapholunate interosseous ligament. At an average follow-up of 28 months (range 12-44 months), 9 patients were asymptomatic and had returned to their pre-injury functional level. One patient developed wrist discomfort and mechanical symptoms 7 months postoperatively and required revision surgery (arthroscopic debridement).
Scapholunate interosseous ligament injuries represent a spectrum of severity from stable tears of the membranous portion of the ligament to complete disruption of the structurally important dorsal and palmar ligamentous supports. Consideration for electrothermal collagen shrinkage should be limited to cases with scapholunate interosseous ligament laxity without dorsal/palmar ligament disruption. Additional outcome studies are necessary to refine the surgical indications, to determine an appropriate length of postoperative wrist immobilization, and to assess for early and late complications (e.g., nerve injury, chondrolysis, scapholunate instability, SLAC) following electrothermal shrinkage. It must be noted that this technique has fallen somewhat out of favor in the shoulder literature after great initial enthusiasm for the treatment of capsular instability.
Related Links
Journal of Hand Surgery