The 2003 Annual Meeting of OASYS_NEW

Not yet assigned to a slot - 2:40 AM

Electrothermal Shrinkage in Interosseous Ligament Tears

Geissler W, Orthopaedic Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, USA

Management of tears to the interosseous ligament differs significantly, depending on whether the lesion is acute or chronic. The purpose of this study was to determine if there is a role for electrothermal shrinkage in chronic partial tears to the intracarpal ligaments of the wrist. Nineteen patients with chronic isolated tears of the scapholunate or lunotriquetral interosseous ligaments were evaluated. Chronic tears were symptoms greater than six months. Average age was 29 years (range: 16-41) and 11 were males. Tears of the interosseous ligament are classified by the arthroscopic classification proposed by Geissler. Ten patients had chronic partial tears to the scapholunate interosseous ligament. Six patients had Grade II lesions and four patients had Grade III tears to the scapholunate interosseous ligament Nine patients had tears of the lunotriquetral interosseous ligament (four Grade II , five Grade III). Partial tear was debrided with a mechanical shaver. Monopolar electrothermal shrinkage was used to shrink the membranous portion of the interosseous ligament and extend dorsally along the capsule. Patients were immobilized eight weeks and placed in a removable splint for additional four weeks. Patients were evaluated by the Modified Mayo Wrist Score. Average follow-up was eight months (range: 6-22). There were nine excellent, six good , two fair and two poor results. Four of the six Grade II scapholunate interosseous ligament injuries were excellent and two good. Of the four Grade III tears to the scapholunate interosseous ligament, there was one excellent, one good , one fair and one poor result. Three of four patients with Grade II tears to the lunotriquetral interosseous ligament rated excellent result and one rated good. Of five patients with Grade III to the lunotriquetral interosseous ligament, there was one excellent, two good , one fair and one poor result. Grade II lesions had a better result compared to Grade III injuries. Seven of ten patients with Grade II injuries to the interosseous ligament had an excellent result. No patient had a fair or poor result with Grade II injury. Only two of nine patients with a Grade III tear of the interosseous ligament had an excellent result to shrinkage alone. There was no difference in the results of scapholunate or lunotriquetral interosseous ligament shrinkage.