Chronic Reducible Scapholunate Ligament Dissociation: A Simple Surgical Technique for a Complex Injury
Bibliographic record
Abstract
PURPOSE: Report the outcomes following chondrectomy of scapholunate (SL) joint, temporary stabilization of the SL joint using Kirshner wires and extensor carpi radialis longus (ECRL) transfer to dorsal scaphoid pole to restore normal SL gap and correct dorsal intercalated ligament instability deformity. MATERIALS AND METHODS: Retrospective case series of 11 patients with a mean age of 45 years were treated by the senior author 7 months after SL injury. The SL joint cartilage was removed, the SL joint was stabilized temporarily with 2 Kirshner wires for 8 weeks and ECRL tenodesis to scaphoid dorsally. Visual analog scale, disability of the arm, shoulder, and hand score, wrist flexion and extension range of motion, grip strength, return to work, SL gap, and SL angle were evaluated preoperatively and in last follow-up visit after the procedure. Modified Mayo score and complications were evaluated in the last visit. RESULTS: Average follow-up was 15.6 months. In the last follow-up, the average visual analog scale pain score improved significantly from 6.4 to 1.5. Average postoperative grip strength improved significantly compared with preoperative strength (41 to 56 Ib). Average disability of the arm, shoulder, and hand score improved significantly postoperatively (30 to 18 points). Average Mayo score was satisfactory in the last visit. Average SL gap reduced significantly from 4.1 to 2.8 mm and average SL angle decreased significantly from 82 to 62 degrees. Postoperative extension-flexion arc of motion significantly decreased compared with preoperative measurements. SL advanced collapse developed in 1 case after 15 months follow-up. All patients return to regular work at a mean of 16 weeks. CONCLUSIONS: Chronic reducible SL dissociation can be treated affectively with SL chonderectomy, temporary SL stabilization, and ECRL tenodesis to scaphoid to restore radiologic anatomy without compromising strength or work status. LEVEL OF EVIDENCE: Therapeutic type IV.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".