DOS Kongressen 2014 ·
89
Short term result of a stable modified Brunelli 360
degree technique for reconstruction of scapho-lunate
ligament.
Allan Ibsen Sørensen, Jonny Andersson
Clinic of Hand Surgery, University Hospital Sahlgrenska
Background:
Several techniques for reconstruction of the scapho-lunate liga-
ment have been used during the years, but none of the techniques have full
stability of the ligament.
Purpose / Aim of Study:
The aim of the study is to present short term result
of a stable modified Brunelli 360 degree technique for reconstruction of sca-
pho- lunate ligament .
Materials and Methods:
In the modified Brunelli technique a part of FCR ten-
don or Plantaris tendon were tunneled through scaphoideum as Brunelli de-
scribed. Then the tendon graft is tunneled through lunate bone in AP direction
and then passed along the volar capsule to tuberculum of the scaphoid bone
and fixed with either suture at tuberculum or biocomposit screw in scaphoid-
eum. Furthermore the graft is fixed in lunate bone with a biocomposit screw.
Fourteen patients were operated and 2 patients twice, 13 men and 1 woman.
Median age 39,8 years (19-52). Median values are used.
Findings / Results:
Median follow-up 15,6 month (2,8-36,5). Preoperative
SL distance 5,7mm and at follow-up 2,7 mm. Dorsal/volar flexion preopera-
tively 94 (35-185) of normal wrist and at follow-up 77% (40-109), radial/
ulnar flexion 92% (35-193) versus 76% (35-133). Grip strength in KgF preop
40 (11-60) and at follow-up 42 (11-74). VAS pain (mm) preop at rest/activity
19/67 and at FU 0/43. Watsons test preop. positive in 10 of 11 cases and post.
op positive in 2 of 15. DISI in 8 of 13 cases preoperatively compared with one
positive of 13 post. op.. Quick DASH and PRWE preop. 41 and 55 and at follow-
up 23 and 27. There were one superficial pin tract infection and one deep infec-
tion in the two patients who were re- operated due to instability.
Conclusions:
In this small series modified Brunelli 360 degree technique for
reconstruction of scapho-lunate ligament seemed to have promising short term
results with a stable fixation.
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