Table 3.
Treatment of scapholunate dissociation by stage
| Stage | Description | Treatments |
|---|---|---|
| 1 | Incomplete SLL injury | Arthroscopic debridement and electrothermal shrinkage |
| 2 | Complete, repairable SLL injury | Open repair of SLL with K-wire stabilization |
| 3 | Complete, irreparable SLL injury with normal alignment | Dorsal capsulodesis (Blatt) Ligamentoplasties: |
| Mayo Clinic SL ligamentoplasty | ||
| Dorsal intercarpal ligamentoplasty | ||
| Bone-ligament-bone reconstruction | ||
| Dynadesis dynamic ECRL tendon transfer | ||
| 4 | Complete, irreparable SLL injury with reducible malalignment | SL ligamentoplasty with tendon graft: |
| Brunelli and Brunelli, three-ligament tenodesis | ||
| Garcia-Elias modification | ||
| Ross modification | ||
| Corella modification | ||
| Spiral tenodesis | ||
| Reduction–association of the scapholunate | ||
| 5 | Complete SLL injury with irreducible malalignment, normal joint cartilage | Partial fusions: |
| Scaphoid-trapezium-trapezoid arthrodesis | ||
| Scapholunate arthrodesis | ||
| Scaphoid-capitate arthrodesis | ||
| Scaphoid-lunate-capitate arthrodesis | ||
| Radioscaphoid-lunate arthrodesis and distal scaphoidectomy | ||
| 6 | Complete SLL injury with irreducible malalignment and cartilage damage | Radial styloidectomy |
| Scaphoidectomy and midcarpal fusion | ||
| Proximal row carpectomy | ||
| Total wrist arthrodesis |
Note: Data from Garcia-Elias et al.48
Abbreviations: ECRL, extensor carpi radialis longus; SL, scapholunate; SLL, scapholunate ligament.