Midterm results of arthroscopic treatment of scapholunate ligament lesionsassociated with intra-articular distal radius fractures

Since 1993, we have treated 30 patients with acute intra-articular distal r adius fractures using arthroscopic assistance. Concomitant lesions of the i ntrinsic scapholunate (SL) ligaments were diagnosed in 12 patients (40%). U sing the grading system of Geissler et al. [13], the identified lesions inc luded a single grade I tear, three grade II, six grade III, and two grade I V. The grade III and IV lesions were accompanied by intra-operative finding s of marked instability. Therefore operative stabilization was performed by temporary scapholunate and scaphocapitate arthrodesis. Seven patients in t his group (87.5%) were followed up clinically and radiologically for an ave rage of 3 years postoperatively. Clinical examination included range of mot ion and a subjective questionnaire concerning pain and ability to work. Obj ective grip strength was measured using a Jamar-tester and compared to the contralateral wrist. Radiological evaluation consisted of posteroanterior a nd lateral views and of stress views in radial and ulnar deviation. Data we re evaluated by the scoring systems of Jakim et al. [21], Cooney et al. [5] and by the demerit point system of Gartland and Werley [12], as modified b y Sarmiento et al. [36]. An excellent result was present in 100% of our pat ients by the Gartland and Werley system, in 86% by that of Jakim et al., an d in 60% by that of Cooney et al. Based on a subjective questionnaire, all of the patients had an excellent or good result.