Failures of the three-ligament tenodesis for chronic static scapholunate dissociation are due to insufficient reduction.
Acta Orthop Belg
Department of Orthopaedic Surgery, Upper Limb Surgery, University Hospitals of Leuven, Pellenberg Campus, Pellenberg, Belgium.
Published: October 2011
We retrospectively reviewed 13 patients who had successfully undergone three-ligament tenodesis for scapholunate instability, and compared the radiological outcome with 14 failed cases. The scapholunate angle in the failed group increased from 73 degrees to 81 degrees with a scapholunate gap of 532 mm, compared to a decrease in the successful group from 76 degrees to 66 degrees with a scapholunate gap of 2.94 mm. Postoperative radiographs may thus have a prognostic value and can also be used if confronted with a patient with persisting symptoms after operation. Salvage procedures may offer a better solution when tenodesis has failed and reduction is insufficient on radiographs, and we believe that redo operations are not indicated, when the initial reduction already failed.
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