T Pillukat1, R A Fuhrmann2, J Windolf3, J van Schoonhoven4. 1. Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland. t.pillukat@handchirurgie.de. 2. Klinik für Fußchirurgie, Bad Neustadt an der Saale, Deutschland. 3. Klinik für Unfall- und Handchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland. 4. Klinik für Handchirurgie, Salzburger Leite 1, 97616, Bad Neustadt an der Saale, Deutschland.
Abstract
OBJECTIVE: Stabilization of the lunotriquetral junction. INDICATIONS: Dynamic and static chronic instability without fixed dislocation of the carpals. CONTRAINDICATIONS: Chronically fixed dislocation of the carpals, ulnar impaction syndrome, osteoarthritis of the joint between hamate and triquetrum and other parts of the wrist joint, rheumatoid arthritis, chondrocalcinosis. SURGICAL TECHNIQUE: Restoration of the palmar portion of the lunotriquetral ligament using a distally based strip of the extensor carpi ulnaris tendon with temporary fixation of the lunotriquetral junction with K-wires. POSTOPERATIVE MANAGEMENT: Immobilization for 8 weeks with a radial cast that includes the first metacarpophalangeal joint. Removal of the K-wires after 8 weeks and exercise. RESULTS: The procedure with rare complications reliably restores stability of the lunotriquetral junction. Reduction of grip strength, pain during exercise, and a reduced range of motion persist. Overall, the results are predominantly good and excellent.
OBJECTIVE: Stabilization of the lunotriquetral junction. INDICATIONS: Dynamic and static chronic instability without fixed dislocation of the carpals. CONTRAINDICATIONS: Chronically fixed dislocation of the carpals, ulnar impaction syndrome, osteoarthritis of the joint between hamate and triquetrum and other parts of the wrist joint, rheumatoid arthritis, chondrocalcinosis. SURGICAL TECHNIQUE: Restoration of the palmar portion of the lunotriquetral ligament using a distally based strip of the extensor carpi ulnaris tendon with temporary fixation of the lunotriquetral junction with K-wires. POSTOPERATIVE MANAGEMENT: Immobilization for 8 weeks with a radial cast that includes the first metacarpophalangeal joint. Removal of the K-wires after 8 weeks and exercise. RESULTS: The procedure with rare complications reliably restores stability of the lunotriquetral junction. Reduction of grip strength, pain during exercise, and a reduced range of motion persist. Overall, the results are predominantly good and excellent.
Authors: F Unglaub; M F Langer; J M Unglaub; M Sauerbier; L P Müller; H Krimmer; P Hahn; C K Spies Journal: Unfallchirurg Date: 2017-06 Impact factor: 1.000