Biomechanical Comparisons of Different Reconstructive Techniques for Scapholunate Dissociation: A Cadaveric Study
There are many techniques for the treatment of chronic scapholunate dissociation. The three-ligament tenodesis (3LT) is used most widely, but reconstruction of the dorsal ligament alone may not provide sufficient stability. The Mark–Henry technique (MHT) compensates for the insufficient stability of...
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MDPI AG
2023-11-01
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| Series: | Bioengineering |
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| Online Access: | https://www.mdpi.com/2306-5354/10/11/1310 |
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| author | Il-Jung Park Seungbum Chae Dai-Soon Kwak Yoon-Vin Kim Seunghun Ha Dohyung Lim |
| author_facet | Il-Jung Park Seungbum Chae Dai-Soon Kwak Yoon-Vin Kim Seunghun Ha Dohyung Lim |
| author_sort | Il-Jung Park |
| collection | DOAJ |
| description | There are many techniques for the treatment of chronic scapholunate dissociation. The three-ligament tenodesis (3LT) is used most widely, but reconstruction of the dorsal ligament alone may not provide sufficient stability. The Mark–Henry technique (MHT) compensates for the insufficient stability of 3LT by additional reconstruction of the volar ligament, but the procedure is complex. The SwiveLock technique (SWT), a recently introduced method, provides stability by using autologous tendons with synthetic tapes, but lacks long-term clinical results. To perform biomechanical comparisons of different reconstructive techniques for scapholunate dissociation using a controlled laboratory cadaveric model. Eleven fresh-frozen upper-extremity cadaveric specimens were prepared. The scapholunate distance, scaphoid rotation, and lunate rotation of the specimens were measured during continuous flexion–extension and ulnar–radial deviation movements. The data were collected using a wrist simulator with a linear guide rail system (tendon load/motion-controlled system) and a motion capture system. Results were compared in five conditions: (1) intact, (2) scapholunate dissociation, (3) SWT, (4) 3LT, and (5) MHT. Paired <i>t</i>-test was employed to compare the biomechanical characteristics of intact wrists to those of scapholunate dissociated wrists, and to those of wrists after each of the three reconstruction methods. SWT and MHT were effective solutions for reducing the widening in scapholunate distance. According to the radioscaphoid angle, all three reconstruction techniques were effective in addressing the flexion deformity of the scaphoid. According to the radiolunate angle, only SWT was effective in addressing the extension deformity of the lunate. In terms of scapholunate angle, only the results after SWT did not differ from those of the intact wrist. The SWT technique most effectively improved distraction intensity and rotational strength for the treatment of scapholunate dissociation. Taking into account the technical complexity of 3LT and MHT, SWT may be a more efficient technique to reduce operating time and minimize complications due to multiple incisions, transosseous tunnels, and complicated shuttling. |
| first_indexed | 2024-03-09T17:00:10Z |
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| language | English |
| last_indexed | 2024-03-09T17:00:10Z |
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| spelling | doaj.art-012918679f0941ef93df465c171af6452023-11-24T14:29:55ZengMDPI AGBioengineering2306-53542023-11-011011131010.3390/bioengineering10111310Biomechanical Comparisons of Different Reconstructive Techniques for Scapholunate Dissociation: A Cadaveric StudyIl-Jung Park0Seungbum Chae1Dai-Soon Kwak2Yoon-Vin Kim3Seunghun Ha4Dohyung Lim5Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Orthopedic Surgery, Daegu Catholic University Medical Center, School of Medicine, Daegu Catholic University, Deagu 42472, Republic of KoreaCatholic Institute for Applied Anatomy, Department of Anatomy, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Mechanical Engineering, Sejong University, Seoul 05006, Republic of KoreaThere are many techniques for the treatment of chronic scapholunate dissociation. The three-ligament tenodesis (3LT) is used most widely, but reconstruction of the dorsal ligament alone may not provide sufficient stability. The Mark–Henry technique (MHT) compensates for the insufficient stability of 3LT by additional reconstruction of the volar ligament, but the procedure is complex. The SwiveLock technique (SWT), a recently introduced method, provides stability by using autologous tendons with synthetic tapes, but lacks long-term clinical results. To perform biomechanical comparisons of different reconstructive techniques for scapholunate dissociation using a controlled laboratory cadaveric model. Eleven fresh-frozen upper-extremity cadaveric specimens were prepared. The scapholunate distance, scaphoid rotation, and lunate rotation of the specimens were measured during continuous flexion–extension and ulnar–radial deviation movements. The data were collected using a wrist simulator with a linear guide rail system (tendon load/motion-controlled system) and a motion capture system. Results were compared in five conditions: (1) intact, (2) scapholunate dissociation, (3) SWT, (4) 3LT, and (5) MHT. Paired <i>t</i>-test was employed to compare the biomechanical characteristics of intact wrists to those of scapholunate dissociated wrists, and to those of wrists after each of the three reconstruction methods. SWT and MHT were effective solutions for reducing the widening in scapholunate distance. According to the radioscaphoid angle, all three reconstruction techniques were effective in addressing the flexion deformity of the scaphoid. According to the radiolunate angle, only SWT was effective in addressing the extension deformity of the lunate. In terms of scapholunate angle, only the results after SWT did not differ from those of the intact wrist. The SWT technique most effectively improved distraction intensity and rotational strength for the treatment of scapholunate dissociation. Taking into account the technical complexity of 3LT and MHT, SWT may be a more efficient technique to reduce operating time and minimize complications due to multiple incisions, transosseous tunnels, and complicated shuttling.https://www.mdpi.com/2306-5354/10/11/1310scapholunate dissociationreconstructive techniquescadaveric biomechanical study |
| spellingShingle | Il-Jung Park Seungbum Chae Dai-Soon Kwak Yoon-Vin Kim Seunghun Ha Dohyung Lim Biomechanical Comparisons of Different Reconstructive Techniques for Scapholunate Dissociation: A Cadaveric Study Bioengineering scapholunate dissociation reconstructive techniques cadaveric biomechanical study |
| title | Biomechanical Comparisons of Different Reconstructive Techniques for Scapholunate Dissociation: A Cadaveric Study |
| title_full | Biomechanical Comparisons of Different Reconstructive Techniques for Scapholunate Dissociation: A Cadaveric Study |
| title_fullStr | Biomechanical Comparisons of Different Reconstructive Techniques for Scapholunate Dissociation: A Cadaveric Study |
| title_full_unstemmed | Biomechanical Comparisons of Different Reconstructive Techniques for Scapholunate Dissociation: A Cadaveric Study |
| title_short | Biomechanical Comparisons of Different Reconstructive Techniques for Scapholunate Dissociation: A Cadaveric Study |
| title_sort | biomechanical comparisons of different reconstructive techniques for scapholunate dissociation a cadaveric study |
| topic | scapholunate dissociation reconstructive techniques cadaveric biomechanical study |
| url | https://www.mdpi.com/2306-5354/10/11/1310 |
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