Comparison between two dorsal capsuloplasty techniques for chronic injuries of the scapho-lunate ligament
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ORIGINAL PAPER
Comparison between two dorsal capsuloplasty techniques for chronic injuries of the scapho-lunate ligament Norman Della Rosa 1 & Nicolò Bertozzi 2
&
Lancellotti Enrico 3 & Duca Vito 4 & Roberto Adani 1
Received: 28 October 2019 / Accepted: 4 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction The aim of this study was to compare the outcomes of patients undergoing two different dorsal capsuloplasty techniques, the senior author modified Viegas’ and the Berger’s ones in order to determine which of them could provide the best functional outcome, while also improving the radiological findings at long-term follow-up. Methods This retrospective study included a population of 40 patients suffering from chronic partial scapho-lunate ligament injury corresponding to type III in Geissler’s classification. Patients were divided into two groups of 20 patients each where group A underwent Viegas’ capsuloplasty while group B underwent Berger’s one. Pre- and postoperative evaluations included patients’ related wrist/hand evaluation test, grip strength test, radio-lunate and scapho-lunate angles analysis, and flexion-extension range of motion evaluation. Statistical analysis was performed. Both capsuloplasty techniques evaluated represent an effective treatment for chronic partial lesions of the SL ligament (Geissler type III). Results Both techniques resulted in resolution of pain with significant improvement of all clinical, functional, and radiological parameters, although there were marked differences between them. Indeed, higher recovery of autonomy, grip strength, wrist flexion, and reduction in the scapho-lunate angle were observed in patients that underwent Viegas’capsuloplasty. Moreover, both work and sport resumption rates were higher even though the difference wasn’t statistically significant. Conclusions By direct comparison between the two techniques, it emerged that the modified Viegas’ capsuloplasty was more effective than Berger’s in terms of recovery of grip strength, disability, shooting of the wrist joint (especially flexion), and correction of the carpal angles (particularly the scapho-lunate angle). We believed that the modified Viegas’ technique may be regarded as a better choice for the treatment of chronic partial lesions of the SL ligament (Geissler type III). Level of evidence: Level III, therapeutic study. Keywords Scapho-lunate ligament injuries . Geissler’s classification . Dorsal capsulotomy . Wrist trauma . Hand trauma
Introduction Scapho-lunate (SL) dissociation is probably the most common cause of carpal instability dissociative, especially * Nicolò Bertozzi [email protected] 1
Department of Hand Surgery and Microsurgery, Azienda Ospedaliero-Universitaria Policlinico of Modena, Largo del Pozzo 1, 41100 Modena (MO), Italy
2
OU of Plastic and Reconstructive Surgery, Policlinico San Martino, University of Genova, Largo Rosanna Benzi 10, 16132 Genova (GE), Italy
3
Neuromotor and Rehabilitation Department, Arcispedale S. Mari
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