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Management of Scapholunate Ligament Pathology

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Wrist and Elbow Arthroscopy

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Abstract

The challenges presented by pathology of the Scapholunate Ligament (SLL) complex require a thorough understanding of the anatomy and pathomechanics of the relevant structures. The history will not always yield the stereotypical acute high-energy traumatic insult to the wrist and cumulative injury needs to be considered.

Plain radiographs (static and stress) remain an important tool in the diagnostic imaging armamentarium; however, there is increasing interest in advanced and high-resolution Magnetic Resonance Imaging techniques. However, arthroscopy remains the gold standard. SLL pathology may be classified using temporal or structural parameters.

Treatment algorithms are challenging due to the lack of agreement on what defines acute versus chronic injuries. The focus should be on the biological capacity of the ligament to heal rather than arbitrary time frames. Treatment options can be grouped into broad categories: closed pinning (arthroscopic or image assisted), open repair, capsulodesis/capsulorrhaphy/partial repair, reconstruction, and salvage.

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Acknowledgements

We would like to acknowledge Dr Nick Daunt, Radiologist, QLD XRay for his assistance with the “Imaging” section of the chapter. We would also like to acknowledge Susan Peters, Senior Research Coordinator and Hand Therapist, Brisbane Hand and Upper Limb Research Institute for assistance with manuscript preparation.

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Authors and Affiliations

  1. Brisbane Hand and Upper Limb Research Institute, 9/259 Wickham Terrace, Brisbane, 4000, QLD, Australia

    Mark Ross M.B.B.S., F.R.A.C.S. (Orth), Jeremy Loveridge M.B.B.S., F.R.A.C.S. (Orth) & Gregory Couzens M.B.B.S., F.R.A.C.S. (Orth)

  2. Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson, MS, USA

    William B. Geissler M.D.

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  1. Mark Ross M.B.B.S., F.R.A.C.S. (Orth)
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  2. William B. Geissler M.D.
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  3. Jeremy Loveridge M.B.B.S., F.R.A.C.S. (Orth)
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  4. Gregory Couzens M.B.B.S., F.R.A.C.S. (Orth)
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Correspondence to Mark Ross M.B.B.S., F.R.A.C.S. (Orth) .

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  1. Department of Orthopedic Surgery, University of Mississippi, Jackson, Mississippi, USA

    William B. Geissler

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Ross, M., Geissler, W.B., Loveridge, J., Couzens, G. (2015). Management of Scapholunate Ligament Pathology. In: Geissler, W. (eds) Wrist and Elbow Arthroscopy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1596-1_10

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