Bootsman, J.J. (2020) Reconstruction of the scapholunate ligament with fixation using Arthrex bio-tenodesis screws improves early postoperative outcomes: a prospective non-randomized trial. thesis, Medicine.
Full text available on request.Abstract
Introduction Scapholunate ligament injury is relatively common and can have large consequences when not surgically corrected. The most used techniques provide good results, but are followed by disabling postoperative immobilization of 6-7 weeks and mean 9 months of hand therapy. However, interference screws for tendon-to-bone fixation provides an early release to full weight bearing. In this non-randomized prospective trial, we compared scapholunate reconstruction with the use of interference screws and one week postoperative immobilization (anchor group) with reconstruction without interference screws and 6 weeks immobilization (control group) for early postoperative functional and clinical outcomes. Methods 22 patients with a mean age of 43 years were treated with the three-ligament tenodesis technique, 11 with and 11 without interference screws. All patients had reducible chronic scapholunate dissociation without chondral lesions. Pain, function, mobility and strength were evaluated preoperatively, 6 weeks and 3 months postoperatively. Results Six weeks postoperative, the decrease of extension was significantly worse in the control group than in the anchor group (mean -26.6º versus -9.5º). Three months postoperative, in the anchor group, mean flexion and extension were respectively 38.2º and 58.6º, and in the control group respectively 35.3º and 55.5º. After three months, the anchor group reported significantly decreased mean pain and PRWHE score compared to preoperatively, while no significant changes were observed within the control group. Conclusion In our study population, scapholunate ligament reconstruction according to the three-ligament tenodesis technique with fixation using Arthrex bio-tenodesis screws provided improved postoperative clinical and functional outcomes within the first three months, compared to the three-ligament tenodesis technique with fixation using anchor sutures.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Kemler, Dr. M.A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Aug 2023 11:11 |
| Last Modified: | 25 Aug 2023 11:11 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3648 |
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