Scapholunate ligament tears: interest of wrist arthroscopy, therapeutic propositions about a series of 62 patients

Scapholunate ligament tears cause chronic instability leading toSLAC.Wrist arthroscopy allows to see the lesions, even at an early stage,and to treat them with a simple K-Wires fixation in acute cases.Patients were treated on an outpatient basis with tourniquet andunder regional anaesthesia.In acute cases, the scapholunate dissociation was reduced by externaland internal manoeuvres. The fixation was done with two pinsunder arthroscopic and fluoroscopic control.In chronic lesions, after wrist arthroscopy check, fixation of scapholunatejoint was performed with a staple for 6 months, combinedwith a ligamentoplasty with ECRL.We report a series of 62 patients. T here were 42 acute cases and 21chronic lesions. Forty five patients were males and 17 females. Theaverage age of patients was 34 years (range : 18 to 55) .Average follow-up in acute cases was 37 months (range: 14 to 49).According the “Mayo Wrist Score” 92 % of good or excellent resultswere obtained.In chronic cases, average follow-up was 20 months (range: 12 to37). According the “Mayo Wrist Score” 67 % of good or excellentresults were obtained. Poor results were related to age or length oftime between injury and treatment. Wrist arthroscopy is the besttechnique for early diagnosis, and assures the best functional results.