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Internal Brace for Carpal Instability

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Wrist and Elbow Arthroscopy with Selected Open Procedures

Abstract

Scapholunate (SL) instability is a spectrum of injuries that ranges from dynamic instability to static instability. In order to prevent the development of abnormal wrist biomechanics and degenerative changes in the carpus, surgery is recommended to restore ligamentous continuity and preserve wrist function. An abundance of surgical techniques has been described with varied success. Post-operatively, symptoms and pain improve, but patients can experience a decrease in range of motion and grip strength. Long-term, no technique has consistently shown the ability to prevent SL gapping and carpal malalignment. Internal bracing is a novel technique that has been utilized to augment ligament repairs and reconstructions in joints in both the lower and upper extremities with great success. The advantages of internal bracing include greater biomechanical strength at time zero and protection of the healing ligament while allowing early mobilization and expedited rehabilitation and recovery. The internal brace has been utilized in the surgical management of SL instability with three types of repairs: all-dorsal SL reconstruction, SL interosseous reconstruction, and SL ligament intrinsic brace 360° tenodesis (SLITT) reconstruction. Follow-up data for these novel techniques is pending, but early anecdotal experience with these techniques has been encouraging and will be described in detail in this chapter.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY, USA

    Robert M. Zbeda

  2. Surgery of the Hand/Upper Extremity, Lenox Hill Hospital, New York, NY, USA

    Steven J. Lee

  3. Nicholas Institute of Sports Medicine and Athletic Trauma, New York, NY, USA

    Steven J. Lee

Authors
  1. Robert M. Zbeda
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  2. Steven J. Lee
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Editor information

Editors and Affiliations

  1. Division of Hand and Upper Extremity Surgery Section of Arthroscopic Surgery and Sports Medicine, Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson, MS, USA

    William B. Geissler

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Zbeda, R.M., Lee, S.J. (2022). Internal Brace for Carpal Instability. In: Geissler, W.B. (eds) Wrist and Elbow Arthroscopy with Selected Open Procedures. Springer, Cham. https://doi.org/10.1007/978-3-030-78881-0_16

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  • DOI: https://doi.org/10.1007/978-3-030-78881-0_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-78880-3

  • Online ISBN: 978-3-030-78881-0

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