Scapholunate and lunotriquetral interosseous ligament augmentation with internal bracing in perilunate dislocation

Context: Injury to the anterior cruciate ligament (ACL) is among the most common orthopaedic injuries, and reconstruction of a ruptured ACL is a common orthopaedic procedure. In general, surgical intervention is necessary to restore stability to the injured knee, and to prevent meniscal damage. Along with surgery, intense postoperative physical therapy is needed to restore function to the injured extremity. ACL reconstruction (ACLR) has been the standard of care in recent decades, and advances in surgical technology have reintroduced the prospect of augmented primary repair of the native ACL via a variety of methods. Evidence Acquisition: A search of PubMed database of articles and reviews available in English was performed through 2020. The search terms ACLR, anterior cruciate ligament repair, bridge enhanced acl repair, suture anchor repair, dynamic intraligamentary stabilization, internal bracing, suture ligament augmentation, and internal brace ligament augmentation were used. Study Design: Clinical review. Level of Evidence: Level 5. Results: No exact consensus exists on effective rehabilitation protocols after ACL repair techniques, as the variation in published protocols seem even greater than the variation in those for ACLR. For some techniques such as internal bracing and dynamic interligamentary stabilization, it is likely permissible for the patients to progress to full weightbearing and discontinue bracing sooner. However, caution should be applied with regard to earlier return to sport than after ACLR as to minimize risk for retear. Conclusion: More research is needed to address how physical therapies must adapt to these innovative repair techniques. Until that is accomplished, we recommend that physical therapists understand the differences among the various ACL surgery techniques discussed here and work with the surgeons to develop a rehabilitation protocol for their mutual patients. Strength of Recommendation Taxonomy (SORT): C.

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Comparison of Three Different Internal Brace Augmentation Techniques for Scapholunate Dissociation: A Cadaveric Biomechanical Study

Journal of Clinical Medicine ◽

10.3390/jcm10071482 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1482

Author(s):

Il-Jung Park ◽

Dohyung Lim ◽

Mauro Maniglio ◽

Steven S. Shin ◽

Seungbum Chae ◽

...

Keyword(s):

Three Dimensional ◽

High Strength ◽

Biomechanical Study ◽

Scapholunate Dissociation ◽

Interosseous Ligament ◽

Short Transverse ◽

Internal Bracing ◽

Internal Brace ◽

Augmentation Techniques ◽

Fresh Frozen

Internal bracing (IB) is an augmentation method using high-strength nonabsorbable tape. However, there is no detailed information about the direction, location, or number of IBs required for scapholunate interosseous ligament (SLIL) injury repair. Thus, this study compared the biomechanical characteristics of short-transverse IB, long-oblique IB, and the combination of short-transverse and long-oblique (Combo) IB for SLIL injury in a biomechanical cadaveric model. We prepared nine fresh-frozen full upper extremity cadaveric specimens for this study. The scapholunate distance, scapholunate angle, and radioscaphoid angle were measured using the MicroScribe digitizing system with the SLIL intact, after scapholunate dissociation and the three different reconstructions. Three-dimensional digital records were obtained in six wrist positions in each experimental condition. Short-transverse IB had a similar effect compared with long-oblique IB in addressing the widening of the scapholunate distance. However, both were less effective than Combo IB. For scaphoid flexion deformity, short-transverse IB had minimal effect, while long-oblique IB had a similar effect compared to Combo IB. Combo IB was the most effective for improving distraction intensity and rotational strength. This study provides important information about the biomechanical characteristics of three different IB methods for SLIL injury and may be useful to clinicians in treating scapholunate dissociation.

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Radio-Ulnar Synostosis Complicating Partial Mid-Diaphyseal Ulnar Ostectomy in Growing Dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633140 ◽

1992 ◽

Vol 05 (01) ◽

pp. 26-30 ◽

Cited By ~ 10

Author(s):

G. C. MacPherson ◽

K. A. Johnson

Keyword(s):

The Other ◽

Interosseous Ligament

SummaryRadio-ulnar synostosis developed in two dogs that had partial mid-diaphyseal ulnar ostectomies performed to correct asynchronous growth of the radius and ulna. The synostosis was apparently painful and caused lameness in one dog, and exacerbated humero-ulnar subluxation in the other dog. Periosteal and interosseous ligament trauma, together with the location of the ulnar ostectomy, radial overstrain and radial hypertrophy were considered to be important factors in the pathogenesis of synostosis formation in these cases.Radio-ulnar synostosis was a complication of mid-diaphyseal ulnar ostectomy in two young dogs.

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RetroBRACE - Clinical and Functional Outcomes 2 Years After Primary ACL Repair (Internal Bracing)

Case Medical Research ◽

10.31525/ct1-nct03997071 ◽

2019 ◽

Author(s):

Keyword(s):

Functional Outcomes ◽

Acl Repair ◽

Internal Bracing

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Kinematic analysis of two scapholunate ligament reconstruction techniques

Journal of Orthopaedic Surgery ◽

10.1177/23094990211025830 ◽

2021 ◽

Vol 29 (2) ◽

pp. 230949902110258

Author(s):

Seungbum Chae ◽

Junho Nam ◽

Il-Jung Park ◽

Steven S. Shin ◽

Michelle H. McGarry ◽

...

Keyword(s):

Kinematic Analysis ◽

Clinical Relevance ◽

Ligament Reconstruction ◽

Operative Time ◽

Efficient Technique ◽

Scapholunate Ligament ◽

Interosseous Ligament ◽

Flexion Extension

Purpose: This study compares the kinematic changes after the procedures for scapholunate interosseous ligament (SLIL) reconstruction—the modified Brunelli technique (MBT) and Mark Henry’s technique (MHT). Methods: Ten cadaveric wrists were used. The scapholunate (SL) interval and angle and radiolunate (RL) angle were recorded using the MicroScribe system. The SL interval was measured by dividing the volar and dorsal portions. Four motions of the wrist were performed—neutral, flexion, extension, and clenched fist (CF) positions—and compared among five conditions: (1) intact wrist, (2) volar SLIL resection, (3) whole SLIL resection, (4) MBT reconstruction, and (5) MHT reconstruction. Results: Under the whole SLIL resection condition, the dorsal SL intervals were widened in all positions. In all positions, the dorsal SL intervals were restored after MBT and MHT. The volar SL interval widened in the extension position after volar SLIL resection. The volar SL interval was not restored in the extension position after MBT and MHT. The SL angle increased in the neutral and CF positions under the whole SLIL resection condition. The SL angle was not restored in the neutral and CF positions after MBT and MHT. The RL angle increased in the neutral and CF positions under the whole SLIL resection condition. The RL angle was not restored in the neutral and CF positions after MBT and MHT. Conclusion: The MBT and MHT may restore the dorsal SL interval. No significant differences in restoration of the SL interval between MBT and MHT were found in the cadaveric models. Clinical relevance: No significant differences between MBT and MHT were found in the cadaveric models for SLIL reconstruction. When considering the complications due to volar incision and additional procedures in MHT, MBT may be a more efficient technique in terms of operative time and injury of the anterior structures during surgery, but further research is needed.

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