Abstract：
Injury to the scapholunate complex is the cause of scapholunate instability which can lead to radiocarpal and medio-carpal osteoarthritis. Several ligamentoplasty techniques have been reported for the treatment of chronic scapholunate instability before the osteoarthritis stage. The objective of this study was to assess the short-term results of an \"all dorsal scapholunate repair\" ligamentoplasty. We report the clinical, radiological and functional results of a retrospective study including 21 patients, operated between June 2019 and December 2020 for a stage 3 or 4 scapholunate instability according to the Garcia Elias classification. With a follow-up of 14.2 months, the pain was 0.1/10 according to the VAS at rest and 4/10 during exercise. Wrist strength was measured at 65% of the opposite side. The flexion-extension range of motion was 105°. Radiologically, there was a reduction of the diastasis and scapholunate angle. Osteolysis areas around the anchors were described in 47% of patients. The mean QuickDASH was 29.2/100, PRWE 24/100 and Mayo wrist score 67.8/100. Eighty-one percent of patients were satisfied. Seventeen patients had returned to work 5.2 months postoperatively. In the case of work-related injury, the functional scores were poorer, with a delayed return to work. This technique provides encouraging results in the short term. Most patients were improved compared to preoperative state. The work-related injury appears to be a poor prognostic factor. A longer-term study is imperative to confirm the maintenance over time of the correction of carpal malalignment and the evolution of the osteolysis areas.Level of evidence: Level IV Retrospective study.
摘要：
肩胛骨复合体的损伤是肩胛骨不稳定的原因，可导致放射性腕骨和中腕骨关节炎。已经报道了几种韧带成形术技术用于在骨关节炎阶段之前治疗慢性肩胛骨不稳定。这项研究的目的是评估“全肩胛骨背侧修复”韧带成形术的短期结果。我们报告临床，一项包括21例患者的回顾性研究的放射学和功能结果，根据GarciaElias分类，在2019年6月至2020年12月期间进行了3或4级肩capholunate不稳定性手术。随访14.2个月，根据静息时的VAS，疼痛为0.1/10，运动时的疼痛为4/10。在相对侧的65%处测量腕部强度。屈伸运动范围为105°。放射学上,舒张和肩胛骨角度减少。在47％的患者中描述了锚钉周围的骨质溶解区域。平均QuickDASH为29.2/100，PRWE为24/100，Mayo腕部得分为67.8/100。81％的患者感到满意。17名患者术后5.2个月恢复工作。在工伤的情况下，功能评分较差，延迟返回工作。这种技术在短期内提供了令人鼓舞的结果。大多数患者较术前状态有所改善。与工作有关的伤害似乎是不良的预后因素。必须进行更长期的研究，以确认随着时间的推移，腕骨错位矫正的维持以及骨质溶解区域的演变。证据水平：IV级回顾性研究。
