Anatomic C Scapholunate Reconstruction Technique: For Complete Dissociation of the Scapholunate Interval

Abstract

This surgical technique article describes the anatomic C scapholunate reconstruction technique. It is indicated for complete acute or chronic scapholunate ligament dissociation. The technique addresses severe scapholunate interval gapping, ulnar translocation of the lunate, and rotational/dorsal intercalated segment instability. The C-shaped ligament is cradled from dorsal to volar using a symmetric four anchor/synthetic tape construct through a single dorsal incision and hyperflexion of the wrist. It does not require any volar incision/approach, as previously described techniques, and also avoids vascular disruption of the scaphoid ridge. An athlete patient case with illustration is also presented, who was treated with anatomic C scapholunate reconstruction on one wrist and all-dorsal scapholunate reconstruction on the other wrist. The two wrists are compared, and postoperative management with technique pearls and pitfalls are described.