Article

Scapholunate (SL) instability is the most common dissociative carpal instability
condition. It is the most frequent cause of wrist osteoarthritis, defined as
scapholunate advanced collapse or SLAC wrist. Familiarity with the SL ligament
complex is required to understand the various features of SL instability. Damage
to the SL interosseous ligament is the main prerequisite for SL instability;
however the extrinsic, palmar and dorsal ligaments of the carpus also come into
play. When more than 6 weeks has passed since the initial injury event, SL
instability is considered chronic because ligament healing is no longer possible.
Before osteoarthritis sets in and when the SL instability is still reducible
(scaphoid can be reverticalized), ligament reconstruction surgery is indicated.
Since the end of the 1970s, various ligament reconstruction or tenodesis
techniques have been described. These techniques are used in cases of chronic,
dynamic or static reducible SL instability, when no repairable ligament stump and
no chondral lesions are present. The aim is to correct the SL instability using a
free or pedicled tendon graft to reduce pain while limiting the loss of mobility
and protecting against osteoarthritis-related collapse in the long-term. We will
perform a systematic review of the various tenodesis techniques available in the
literature.
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- Ligamentoplastie

Langue : ANGLAIS