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We reviewed 17 patients 64 (range 29–123) months after dorsal radioscaphoid capsulodesis for scapholunate dissociation. Mean loss of key pinch was 13%, grip strength 18%, wrist flexion 22% (p < 0.001), and total wrist ROM 17% (p < 0.005). VAS (0 = best; 100 = worst) was 30(±28) for pain, 43(±30) for function, and 33(±33) for general satisfaction with the outcome. Mean Quick-DASH and PRWE scores were 27 and 34, respectively. The mean scapholunate gap was 3.5 mm before surgery, 1.9 mm after surgery, and 3.3 mm at review. The corresponding scapholunate angles were 63°, 46°, and 70°, respectively. The mean radioscaphoid angle with the wrist maximally flexed was 84° (69–99) for the patients and was 91° (77–103) in ten wrists of volunteers. Six patients had changed their jobs because of the wrist. Three patients stated that they would not have consented to operation if they had known the outcome in advance. Radioscaphoid capsulodesis does not prevent volar flexion of the scaphoid.

Objective: The goal of this study was to demonstrate a methodology to observe the relationship between joint contact pressure and cartilage T2 relaxation times in three-dimensional space. Methods: One subject diagnosed with unilateral scapholunate dissociation had both injured and uninjured wrists scanned using a Siemens 3T Skyra magnetic resonance imaging (MRI) scanner. Four time echo scans were performed with TE ranging 15–61ms with the hand relaxed. T2 maps were constructed using a custom Matlab code, and these maps were registered to anatomical images for the same subject. The anatomical images were used to construct surface contact models and calculate contact pressures for a simple grasp activity in a prior study. Contact pressures and T2 relaxation times were analyzed using regression analysis. Results and Conclusion: This study demonstrates the feasibility of comparing T2 relaxation times and contact pressure data. For this single demonstration subject, it is not surprising that no relationship was found between T2 relaxation times for the articular cartilage and contact pressures in the normal wrist, contact pressures in the wrist with injury, nor contact pressure changes due to injury. However, the method has been demonstrated and may be useful to evaluate the influence of joint injuries or other pathologies on T2 relaxation times in the context of changes in joint contact pressures with larger cohorts of subjects.

Background: To review the impact that arthroscopy has made on the assessment and treatment of intercarpal (scapholunate [SL] or lunotriquetral [LT]) ligament injuries associated with acute distal radius fractures (DRF).

Methods: A systematic review of EMBASE, MEDLINE and COCHRANE databases for articles published between 2011 and 2021 was performed (PROSPERO ID: CRD42021273293) which included studies reported assessment and outcomes of intercarpal ligament injuries associated with acute DRF. Methodological quality was evaluated. The rate of concomitant injury detection, role of arthroscopy and different clinical outcome assessment measurements used were compared between studies.

Results: A total of 20 articles were included with data from 1,346 patients (1,358 wrists). A total of 1,024 intra-articular fractures were included and 294 extra-articular fractures (40 not specified). There was a heterogeneous mix of studies; 10 comparative and 10 non-comparative. Some studies investigated initial assessment findings only, while others assessed radiological outcomes, functional outcomes or both domains over 0.3–99 months. The overall rate of SL ligament injury associated with DRF was 35.3%, while LT ligament injury overall was 18.2%. More frequent were concomitant triangular fibrocartilage complex (TFCC) injuries (44.8%), although this review did not aim to review these. The role of arthroscopy was reviewed, which included assistance in anatomic reduction of the articular surface and systematic inspection of the surrounding soft tissues. Included studies investigated either assessment or assessment and management of intercarpal ligament injury. Meaningful meta-analysis in this heterogeneous group of studies was not possible. Outcomes of comparative studies were described in detail.

Conclusions: This review suggests that arthroscopy may have a role in improving reduction of intra-articular DRF and diagnosing and managing soft tissue injuries associated with such fractures. Randomised studies are needed to evaluate whether the detection of intercarpal ligament injury in acute distal radial fractures through arthroscopic assessment alters current management and improves clinical outcome.

Level of Evidence: Level III (Therapeutic)