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Anatomy The scapholunate (SL) ligament (SLL) is the most commonly injured carpal ligament. 1 The SLL is C-shaped and has three structurally distinct parts: volar; membranous; and dorsal ( Fig. 1 ). 2 The dorsal part of the SLL is the
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core, visible on radiographs, covered by a radiolucent outer layer of pyrocarbon. A minimal bone resection is required in respect of the anatomical centre of rotation of the joint; collateral ligaments must be preserved or reconstructed. Initial
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implant arthroplasty, even with formal collateral ligament reconstruction and prolonged splinting during rehabilitation ( Fig. 2 ). Arthrodesis should therefore be considered carefully, especially in the radial digits, if the lateral deformation of the PIP
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palmaris longus tendon. Longitudinal fibres form the pre-tendinous bands; transverse fibres form two distinct bands, one proximal (the proximal transverse palmar ligament) and one distal (the natatory ligament), and the vertical fibres (Legueu and Juvara
Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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The Swedish National Patient Insurance Company, Stockholm, Sweden
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Department of Orthopedics, Hässleholm-Kristianstad Hospitals, Hässleholm, Sweden
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usually with a cast. The potentially serious consequences of a non-united scaphoid fracture, as well as missed scapholunate ligament (SL) injuries with progressive osteoarthritis ( 7 , 8 ), have resulted in restrictive treatment protocols for acute
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conclusive evidence ( 1 ). Trapeziectomy, often combined with some sort of ligament reconstruction and tendon interposition is globally most often recommended to patients. The goal of these popular resection arthroplasty procedures is to create a sufficiently
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Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere, Finland
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Department of Orthopaedics and Traumatology, Tampere University Hospital, Finland
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, 15 and they may have an effect on treatment decisions. 15 – 17 If injury of the carpal ligaments is suspected, CT or high-resolution magnetic resonance imaging may be beneficial before a final treatment decision is made. 18 , 19 Several
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secondary to scapholunate instability. Watson and Ballet have described the predictable pattern of degenerative changes that occur when the scapholunate ligament becomes compromised. 1 They refer to this progressive joint destruction as Scapho
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). Double joint dysfunction Nothing is more challenging in hand surgery than the reconstruction of finger motion with the combined pathology of all the tendons, ligaments, and muscles that act across two joints. Mallet finger with secondary swan
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dorsal capsule and the collateral ligaments. The wire is then advanced into the base of the proximal phalanx along its longitudinal axis. A 3.0 mm or 2.2 mm headless compression screw is then inserted ( Fig. 3 ). The guidewire can also be advanced in the
