2016 Volume 29 Issue 4 Pages 273-278
A 33-year-old male injured his wrist when he hit his hand against a rock. At his first visit ( 4 months after the injury ), the scapholunate interval was markedly widened, and the scaphoid ring sign was obvious. We reconstructed the scapholunate ligament with a vascularized bone-ligament-bone graft. The base of the 3rd metacarpal bone, dorsal capsular ligament, and the distal capitate bone were harvested en bloc based on the 2nd dorsal metacarpal artery and grafted to the dorsal aspect of the scaphoid and lunate bones. At 10 postoperative months, his wrist was pain-free, and he had returned to his former job ( delivering gas cylinders to customers ). He exhibited wrist extension and flexion of 30 and 35 degrees, respectively, and the grip strength of the affected hand was 53% of that of the uninjured hand. The patient’s Cooney score was 70 because he had limited wrist motion and grip strength. The use of a vascularized bone-ligament-bone graft to reconstruct the scapholunate ligament has the theoretical advantage of preserving the vascularity of the ligament and bone, which maintains graft strength and promotes early bone union. Long-term follow-up is necessary to confirm the effectiveness of this procedure.
