Reconstruction of both volar and dorsal limbs of the scapholunate interosseous ligament.

Abstract

Complete scapholunate interosseous ligament deficiency can lead to pain, reduced functional performance, and scapholunate advanced collapse arthritis. Efforts to restore carpal stability began with procedures to tether scaphoid motion. Techniques evolved to include multiple differing strategies of linking the scaphoid to the lunate dorsally in the transverse plane. Actually restoring stability has proven elusive owing to the impossibility of truly replicating the original anatomy and the multidirectional forces to which the scapholunate interface is subjected. The described surgical technique differs from others by reconstructing both the volar and dorsal limbs of the scapholunate ligament and accounting for the multiple force vectors involved in scapholunate instability.