Abstract
Lunotriquetral instability is treated based upon degree of instability and concomitant pathology although there is no consensus on treatment of lunotriquetral instability. Lunotriquetral instability, with or without concomitant pathology, has been surgically managed with arthrodesis, ligament graft reconstruction, ligament repair, percutaneous pinning, and ulnar shortening.
In this arthroscopic approach, management of lunotriquetral instability combines arthroscopic soft tissue management with arthroscopic reduction of the lunotriquetral joint and percutaneous pinning. Arthroscopic suture plication of the ulnocarpal ligaments shortens ligament length to act as a checkrein to excessive lunotriquetral motion similar to ligament tightening associated with ulnar shortening. Ligament plication with arthroscopic lunotriquetral reduction and pinning is useful for treatment while minimizing motion losses after surgery and reducing surgical exposure.
Keywords
- Ulnar Variance
- Extensor Carpus Ulnaris
- Arthroscopic Evaluation
- Arthroscopic Reduction
- Ulnar Side Wrist Pain
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Kulick M, Chen C, Swearingen P. Determining the diagnostic accuracy of wrist arthroscopy. Toronto, ON: Annual meeting of the American Society for Surgery of the Hand; 1990.
Palmer C, Murray P, Snearly W. The mechanism of ulnar sided perilunate instability of the wrist. Toronto, ON: Annual meeting of the American Society for Surgery of the Hand; 1998.
Horii E, Gacias-Elias M, An K, et al. A kinematic study of lunato-triquetral dislocations. J Hand Surg Am. 1991;16A:355.
Viegas S, Peterson P, et al. Ulnar-sided perilunate instability: An anatomic and biomechanical study. J Hand Surg Am. 1990;15A:268.
Trumble T, Bour C, Smith R, et al. Kinematics of the ulnar carpus to the volar intercalated segment instability pattern. J Hand Surg Am. 1990;15A:384.
Reagan D, Linscheid R, Dobyns J. Lunatotriquetral sprains. J Hand Surg Am. 1984;9A:502–14.
Kleinman W. Physical examination of lunatotriquetral joint. Am Soc Surg Hand Corr Newsletter. 1985;51:74.
Kleinman W. Long-term study of chronic scapho-lunate instability treated by scapho-trapezio-trapezoid arthodesis. J Hand Surg Am. 1989;14A:429.
Palmer A, Werner F. The triangular fibrocartilage complex of the wrist: anatomy and function. J Hand Surg Am. 1981;6:153.
Palmer A. Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am. 1989;14A:594.
Palmer A, Glisson R, Werner F. Ulnar variance determination. J Hand Surg Am. 1982;7:376.
Gilula L. Posteroanterior wrist radiography: importance of arm positioning. J Hand Surg Am. 1987;12A:504–8.
Hulten O. Uber anatomische variationen der hand-Gelenkknochen. Acta Radiol. 1928;9:155.
Steyers C, Blair W. Measuring ulnar variance: a comparison of techniques. J Hand Surg Am. 1989;14A:607.
Gilula L. Carpal injuries: analytic approach and case exercises. AJR Am J Roentgenol. 1979;133:503–17.
Bednar J, Osterman A. Carpal instability: evaluation and treatment. J Am Acad Orthop Surg. 1993;1:10–7.
Cooney W, Dobyns J, Linscheid R. Arthroscopy of the wrist: anatomy and classification of carpal instability. Arthroscopy. 1990;6:113–40.
Mayfield J. Patterns of injury to carpal ligaments: a spectrum. Clin Orthop. 1984;187:36.
Werner F, Palmer A, Fortino M, et al. Force transmission through the distal ulna: effect of ulnar variance, lunate fossa angulation, and radial and palmar tilt of the distal radius. J Hand Surg Am. 1992;17A:423.
Melone Jr C, Nathan R. Traumatic disruption of the triangular fibrocartilage complex, pathoanatomy. Clin Orthop. 1992;275:65–73.
Green D. Carpal dislocation and instabilities. In: Green D, editor. Operative hand surgery. New York, NY: Churchill Livingston; 1988. p. 878–9.
Palmer A, Werner F. Biomechanics of the distal radioulnar joint. Clin Orthop. 1984;187:26.
Garcias-Elias M, Domenech-Mateu J. The articular disc of the wrist: limits and relations. Acta Anat. 1987;128:51.
Johnson R, Carrera G. Chronic capitolunate instability. J Bone Joint Surg. 1986;68A:1164–76.
Viegas S, Wagner K, Patterson R, et al. Medial (hamate) facet of the lunate. J Hand Surg Am. 1990;15A:564–71.
Pin P, Young V, Gilula L, et al. Management of chronic lunatotriquetral ligament tears. J Hand Surg Am. 1989;14A:77–83.
Osterman A, Sidman G. The role of arthroscopy in the treatment of lunatotriquetral ligament injuries. Hand Clin. 1995;11:41–50.
Seradge H, Sterbank P, Seradge E, et al. Segmental motion of the proximal carpal row: their global effect on the wrist motion. J Hand Surg Am. 1990;15A:236–9.
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Moskal, M.J., Savoie, F.H. (2015). Arthroscopic Management of Lunotriquetral Ligament Tears. In: Geissler, W. (eds) Wrist and Elbow Arthroscopy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1596-1_12
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