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KMID : 0361620110460040294
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Journal of the Korean Orthopaedic Association
2011 Volume.46 No. 4 p.294 ~ p.302
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Intercarpal Ligament Injuries Associated with Distal Radius Fractures : Relation with the Radiographic Findings and Arthroscopic Treatment
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Kim Jong-Pil
Park Young-Ho
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Abstract
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Purpose: The purpose of this study was to analyze the relationship between intercarpal ligament injuries associated with distal radius fracture and the fracture patterns and radiologic parameters, and to report on the clinical results of arthroscopic treatment for these injuries.
Materials and Methods : Fifty-two patients who underwent arthroscopic surgery for intercarpal ligaments injuries associated with distal radius fracture and who had a minimum 1 year follow-up were enrolled. There were 44 patients who sustained scapholunate interosseous ligament injury (SLIL) and 30 patients who sustained lunotriquetral interosseous ligament (LTIL) injury. Among them, 22 patients had both SLIL and LTIL injuries. The carpal ligament injuries were graded according to the Geissler classification and they treated with arthroscopic debridement only for a grade Ⅰ and Ⅱ injury and arthroscopic reduction and percutaneous pinning for a grade Ⅲ and Ⅳ injury. The patients were divided into two groups and we assessed the functional and radiological outcomes: Group 1 consisted of the patients with a grade Ⅰ and Ⅱ injury and group 2 consisted of the patients with a grade Ⅲ and Ⅳ injury.
Results: The preoperative mean radial inclination of group 2 with lunotriquetal interosseous ligament injury was 15.1 ±9.9°, which was significantly different from 20.4±5.1° of group 1, and the extra-articular type injury was more common in group 2 (p＜0.05). On the follow-up radiographs, the mean scapholunate interval measured 2.1±0.5 ㎜ in group 1 and 1.7±0.5 ㎜ in group 2, which was significantly different (p＜0.05).
Conclusion: The grade of LTIL injury combined with distal radius fractures is associated with the loss of radial inclination and the extra-articular fracture type at the time of initial presentation. Complete tears of the SLIL can be stabilized with arthroscopic reduction and percutaneous pinning.
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KEYWORD
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scapholunate interosseous ligament, lunotriquetral interosseous ligament, distal radius fracture, arthroscopic reduction, percutaneous pinning
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