Treatment of isolated injuries of the lunotriquetral ligament - A comparison of arthrodesis, ligament reconstruction and ligament repair

We studied 57 patients with isolated lunotriquetral injuries treated by art hrodesis, direct ligament repair, or ligament reconstruction. The outcomes were compared by using written questionnaires, the Disabilities of the Arm, Shoulder and Hand (DASH) score, range of movement, strength, morbidity and rates of reoperation. Isolated lunotriquetral injury was confirmed by arth roscopy or arthrotomy. The mean age of the patients was 30.7 years (15.4 to 53.7) and the injuries were subacute or chronic in 98.2%. Eight patients u nderwent lunotriquetral reconstruction using a distally-based strip of the tendon of extensor carpi ulnaris, 27 had lunotriquetral repair and 22 had l unotriquetral arthrodesis. The mean follow-up was 9.5 years (2 to 22). The probability of remaining free from complications at five years was 68.6 % for reconstruction, 13.5% for repair, and less than 1% for arthrodesis. O f the lunotriquetral arthrodeses, 40.9% developed nonunion and 22.7% develo ped ulnocarpal impaction. The probability of not requiring further surgery at five years was 68.6% for reconstruction, 23.3% for repair and 21.8% for arthrodesis. The DASH scores for each group were not significantly differen t. Objective improvements in strength and movement, subjective indicators o f pain relief and satisfaction were significantly higher in the lunotriquet ral repair and reconstruction groups than in those undergoing arthrodesis.