Scapholunate Ligament Repair-Bruneli 25320

Scapholunate Ligament Repair-Bruneli CPT

Scapholunate Ligament Repair-Bruneli Anatomy

Scapholunate Ligament Repair-Bruneli Indications

Scapholunate Ligament Repair -Bruneli Contraindications

Scapholunate Ligament Repair-Bruneli Alternatives

Scapholunate Ligament Repair -Bruneli Pre-op Planning / Special Considerations

Scapholunate Ligament Repair-Bruneli Technique

Pre-op antibiotics.
Supine position with hand table.
Anesthesia (regional or general)
EUA compare to uninjured side.
Touniquet high on arm.
Consider Wrist Arthroscopy to confirm diagnosis and examine for arthritic changes.
dorsal incision over 4th compartment
skin flaps elevated
extensor retinaculum incised over 3rd compartment
distally based capsulotomy; preserve dorso lunotriquetral ligament
confirm diagnosis
volar incision over scaphoid tubercle and along FCR
expose scaphoid tubercle
k-wire 1.1mm passed along long axis of scaphoid
overdrill with 2.9mm or 3.2mm cannulated drill
4mm incision over FCR 10mm proximally
harvest volar 1/3 of FCR using Carrol tendon harvester
bent k-wire or hewson suture passer to pass tendon through scaphoid
chondrodesis between scaphoid and lunate with roungeur
flex wrist to reduce lunate and pin in place with k-wire
pass graft under dorsoradiolunotriquetral ligament
place anchor in lunate and suture graft into lunate and itself using anchor
remove kwire
Irrigate.
Repair the capsule and extensor retinaculum.
Repair in layers.

Scapholunate Ligament Repair Complications-Bruneli

Scapholunate Ligament Repair -Bruneli Follow-up care

Long-arm splint in pronation for 4-6 weeks, with frequent follow-up xrays to assess reduction.
At 6 week follow-up change to short-arm splint / cast
Consider occupational therapy if stiffness continues 8 weeks.

Scapholunate Ligament Repair -Bruneli Outcomes

Scapholunate Ligament Repair -Bruneli Review References