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Scapholunate Reconstruction 3LT and Spiral Tenodesis

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Wrist and Elbow Arthroscopy with Selected Open Procedures

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Abstract

Scapholunate dissociation is the most common ligamentous injury of the carpus. There is a spectrum of this injury described in the literature as ranging from the predynamic to static, subacute to chronic, and the ultimate degenerative end point known as scapholunate advanced collapse (SLAC).

A plethora of surgical treatment options to treat this problem has been succinctly described in an algorithm proposed based on a number of objective diagnostic criteria and parameters. Tri-ligament tenodesis (3LT) represents one of the treatment options available to treat patients with dynamic, irreparable but reducible scapholunate dissociation with no onset of degenerative changes. Spiral tenodesis is yet another option aimed at treating patients with more than just the above scapholunate dissociation but rather in an uncommon subgroup of patients with a perilunate instability from a “lesser arc” injury with a predominant scapholunate injury component. It is important to recognize such entity, often misdiagnosed as just scapholunate dissociation of the above type, as failure to do so and application of the incorrect 3LT treatment option will lead to failure and a negative outcome for such patients.

We describe the techniques of both 3LT and spiral tenodesis procedures in detail and highlight the clear indications so as to achieve optimal and favorable outcomes in our patients presenting with such injuries.

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Author information

Authors and Affiliations

  1. Singapore General Hospital, Hand and Reconstructive Microsurgery, Singapore, Singapore

    Andrew Y. H. Chin

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  1. Andrew Y. H. Chin
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Correspondence to Andrew Y. H. Chin .

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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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Chin, A.Y.H. (2022). Scapholunate Reconstruction 3LT and Spiral Tenodesis. 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_19

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  • DOI: https://doi.org/10.1007/978-3-030-78881-0_19

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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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