The pupose of this study is to demonstrate that extensor carpi radialis longus (ECRL) transfer to the scaphoid tubercle can restore wrist stability and synchonous motion in cases of scapholunate dissociation.

Twenty-four patients with acute or chronic scapholunate instability were treated. These patients had no arthritis and a fully reducable scaphoid at the time of surgery. There were 14 males and 10 females. The dominant hand was involved in 11 patients. The average patient age was 37 (range 19-62).

No pins were used. Active range of motion wrist exercises were initiated one month after surgery and strengthing and conditioning exercises were started at 2 months after surgery.

Seventeen of these patients were followed for 4 months or more (average 8 months, range 4-22 months). Using the Green O'Brien Wrist Score there were 2 excellent, 14 good, and 1 fair result. Sixteen of 17 had good to excellent pain relief. The flexion extension arc of wrist motion averaged 93 degress. Five patients with 6 month flexuon extension x-rays averaged 40 degrees of scaphoid flexion extension confirming a functional tendon transfer. Grip strength averaged 60% of the uninvolved side.

We concluded that ECRL transfer to the scaphoid tubercle restores wrist stability. It has an advantage over capsulodesis and tenodesis in regaining synchronous synergistic wrist motion. Early results are encouraging.