Evaluation of the performance of three tenodesis techniques for the treatment of scapholunate instability: flexion-extension and radial-ulnar deviation

Chronic scapholunate ligament (SL) injuries are difficult to treat and can lead to wrist dysfunction. Whilst several tendon reconstruction techniques have been employed in the management of SL instability, SL gap reappearance after surgery has been reported. Using a finite element model and cadaveri...

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Bibliographic Details
Published in:Medical & biological engineering & computing 2018-06, Vol.56 (6), p.1091-1105
Main Authors: Alonso-Rasgado, Teresa, Zhang, Qing-Hang, Jimenez-Cruz, David, Bailey, Colin, Pinder, Elizabeth, Mandaleson, Avanthi, Talwalkar, Sumedh
Format: Article
Language:English
Subjects:
Biomedical and Life Sciences
Biomedical Engineering and Bioengineering
Biomedicine
Cadavers
Computer Applications
Computer simulation
Deviation
Finite element method
Human Physiology
Imaging
Knee
Ligaments
Original
Original Article
Radiology
Reconstruction
Stability
Surgery
Wrist
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Summary:Chronic scapholunate ligament (SL) injuries are difficult to treat and can lead to wrist dysfunction. Whilst several tendon reconstruction techniques have been employed in the management of SL instability, SL gap reappearance after surgery has been reported. Using a finite element model and cadaveric study data, we investigated the performance of the Corella, scapholunate axis (SLAM) and modified Brunelli tenodesis (MBT) techniques. Scapholunate dorsal and volar gap and angle were obtained following virtual surgery undertaken using each of the three reconstruction methods with the wrist positioned in flexion, extension, ulnar deviation and radial deviation, in addition to the ulnar-deviated clenched fist and neutral positions. From the study, it was found that, following simulated scapholunate interosseous ligament rupture, the Corella technique was better able to restore the SL gap and angle close to the intact ligament for all wrist positions investigated, followed by SLAM and MBT. The results suggest that for the tendon reconstruction techniques, the use of multiple junction points between scaphoid and lunate may be of benefit. Graphical abstract The use of multiple junction points between scaphoid and lunate may be of benefit for tendon reconstruction techniques.
ISSN:0140-0118
1741-0444
DOI:10.1007/s11517-017-1748-1