Dynamic correction of scapholunate instability using ECRB tendon transfer

Background. Instability of the wrist, leading to the appearance of a fissure between the scaphoid and lunate bones (SLD), is generally attributed to damage of the scapholunate ligaments (SLIL). However, repair of the SLIL does not give a good outcome. SLD recurs in many cases, despite correct reconstruction. The structures of the joint may be exposed to further overloading and damage, with all the attendant consequences. Material and methods. This article presents the preliminary results of the operative treatment of 7 cases of scapholunate instability. Partial ECRB transfer to the distal pole of the scaphoid was performed. The DASH form was used for outcome assessment. Results. Better alignment and dynamic stabilisation of the scaphoid were achieved. All patients had less pain and better grip strength without limitation of wrist flexion. Conclusions. Preliminary treatment outcomes after dynamic transfer of the ECRB tendon using the method described here are encouraging. Our observations indicate that the dynamic stabilization of rotatory instability of the scaphoid bone can be recommended in cases of predynamic and dynamic scapho-lunate instability.