Diagnóstico y tratamiento artroscópico de la inestabilidad escafolunar

Scapholunate instability is the most common instability of the carpal and covers a wide spectrum of lesions, from a partial scapholunate ligament injury to it complete injury associated with a lesion of the secondary stabilizers. It has usually been classified into pre-dynamic, dynamic and static injury depending on the radiographic findings on the simple and dynamic X-rays. Despite all this, radiological tests have a high percentage of false negatives, thus the “gold standard” technique for the diagnosis of these injuries is, without a doubt, wrist arthroscopy. In this article, as review of the different classifications of scapholunate instability is presented, along with other useful arthroscopic examinations to help in the assessment of this condition described by the authors.

There are numerous techniques available for the arthroscopic treatment of scapholunate instability, and this article will present a review of the most extensively used techniques such as, debridement, electrocoagulation, reduction-association scapholunate (RASL) procedure, and capsuloligamentous suture. Special mention is made to arthroscopic ligamentoplasty, described by the authors, that enables the dorsal and volar reconstruction of the scapholunate ligament.