• OBJECTIVE
    • To investigate the radiographic and clinical outcomes of dorsal intercarpal ligament capsulodesis (DILC) procedure for chronic static scapholunate dissociation.
  • METHODS
    • Between January 2008 and January 2011, 12 patients with chronic static scapholunate dissociation were treated with DILC. Of 12 cases, 10 were male and 2 were female with an average age of 42 years (range, 20-66 years). All injuries were caused by falling. The interval from injury to surgery was 3-19 months (mean, 8 months). Physical examination at admission showed wrist tenderness and limited range of motion (ROM). Radiological examination showed that scapholunate gap was greater than 3 mm on posteroanterior view, and scapholunate angle more than 60° on the lateral view. Before operation, the grip strength was (25.4 ± 8.2) kg; the wrist ROM was (56.7 ± 11.5)° in flexion and (52.0 ± 15.2)° in extension; visual analogue scale (VAS) score was 6.3 ± 1.4; and disabilities of arm, shoulder & hand (DASH) score was 39.5 ± 7.4. According to Garcia-Elias staging criteria, all cases were rated as stage 4, indicating that the scapholunate interosseous ligament was completely injured and reduction could easily be obtained. Eight patients had wrist instability.
  • RESULTS
    • Primary healing of incision was achieved, no complication was found. All patients were followed up 13-34 months (mean, 15.9 months). During surgery, all deformities were corrected completely, but 7 patients (58%) recurred at 1 month after Kirschner wire removal. Compared with preoperative ones, the scapholunate gap, scapholunate angle, radiolunate angle, lunocapitate angle, and wrist height ratio at 1 month after Kirschner wire removal and last follow-up showed no significant difference (P > 0.05); the wrist flexion and extension ROM were significantly decreaed to (46.8 ± 7.2)° and (42.0 ± 9.0)° at last follow-up (P < 0.05); the grip strength was significantly increased to (32.7 ± 9.6) kg at last follow-up (P < 0.05); VAS score and DASH score were improved to 1.7 ± 1.0 and 8.1 ± 8.7 (P < 0.05).
  • CONCLUSION
    • Carpal collapse will recur in short time after DILC. DILC is not the best way to treat chronic static scapholunate dissociation.