One-Year Outcomes of the Anatomical Front and Back Reconstruction for Scapholunate Dissociation
Anatomical front and back (ANAFAB) reconstruction addresses the critical volar and dorsal ligaments associated with scapholunate dissociation. We hypothesized that patients with symptomatic, chronic, late-stage scapholunate dissociation would demonstrate improvements in all radiographic parameters a...
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Veröffentlicht in: | The Journal of hand surgery (American ed.) 2024-04, Vol.49 (4), p.329-336 |
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description | Anatomical front and back (ANAFAB) reconstruction addresses the critical volar and dorsal ligaments associated with scapholunate dissociation. We hypothesized that patients with symptomatic, chronic, late-stage scapholunate dissociation would demonstrate improvements in all radiographic parameters and patient-reported outcomes (PROMs) after ANAFAB reconstruction.
From 2018 to 2021, 21 ANAFAB reconstructions performed by a single surgeon were followed prospectively, with 20 patients having a minimum follow-up of 12 months. In total, 17 men and four women were included, with an average age of 49 years. Three patients had modified Garcia-Elias stage 3 disease, eight stage 4, seven stage 5, and three stage 7. ANAFAB reconstruction of intrinsic and extrinsic ligament stabilizers was performed using a hybrid synthetic tape/tendon graft in a transosseous reconstruction. Pre- and postoperative radiographic parameters, grip, pinch strength, the Patient-Rated Wrist Evaluation, PROMIS Upper Extremity Function, and PROMIS Pain Interference outcome measures were compared.
Mean follow-up was 17.9 months (range: 12–38). Radiographic parameters were improved at follow-up, including the following: scapholunate angle (mean 75.3° preoperatively to 69.2°), scapholunate gap (5.9–4.2 mm), dorsal scaphoid translation (1.2–0.2 mm), and radiolunate angle (13.5° to 1.8°). Mean Patient-Rated Wrist Evaluation scores for pain and function decreased from 40.6 before surgery to 10.4. We were unable to detect a significant difference in grip or pinch strength or radioscaphoid angle with the numbers tested. There were two minor complications, and two complications required re-operations, one patient who was converted to a proximal row carpectomy for failure of fixation, and one who required tenolysis/arthrolysis for arthrofibrosis.
At 17.9-month average follow-up, radiographic and patient-reported outcome parameters improved after reconstruction of the critical dorsal and volar ligament stabilizers of the proximal carpal row with the ANAFAB technique.
Therapeutic IV. |
doi_str_mv | 10.1016/j.jhsa.2023.12.012 |
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From 2018 to 2021, 21 ANAFAB reconstructions performed by a single surgeon were followed prospectively, with 20 patients having a minimum follow-up of 12 months. In total, 17 men and four women were included, with an average age of 49 years. Three patients had modified Garcia-Elias stage 3 disease, eight stage 4, seven stage 5, and three stage 7. ANAFAB reconstruction of intrinsic and extrinsic ligament stabilizers was performed using a hybrid synthetic tape/tendon graft in a transosseous reconstruction. Pre- and postoperative radiographic parameters, grip, pinch strength, the Patient-Rated Wrist Evaluation, PROMIS Upper Extremity Function, and PROMIS Pain Interference outcome measures were compared.
Mean follow-up was 17.9 months (range: 12–38). Radiographic parameters were improved at follow-up, including the following: scapholunate angle (mean 75.3° preoperatively to 69.2°), scapholunate gap (5.9–4.2 mm), dorsal scaphoid translation (1.2–0.2 mm), and radiolunate angle (13.5° to 1.8°). Mean Patient-Rated Wrist Evaluation scores for pain and function decreased from 40.6 before surgery to 10.4. We were unable to detect a significant difference in grip or pinch strength or radioscaphoid angle with the numbers tested. There were two minor complications, and two complications required re-operations, one patient who was converted to a proximal row carpectomy for failure of fixation, and one who required tenolysis/arthrolysis for arthrofibrosis.
At 17.9-month average follow-up, radiographic and patient-reported outcome parameters improved after reconstruction of the critical dorsal and volar ligament stabilizers of the proximal carpal row with the ANAFAB technique.
Therapeutic IV.</description><identifier>ISSN: 0363-5023</identifier><identifier>EISSN: 1531-6564</identifier><identifier>DOI: 10.1016/j.jhsa.2023.12.012</identifier><identifier>PMID: 38244024</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anatomical front and back (ANAFAB) reconstruction ; Female ; Humans ; Joint Instability - diagnostic imaging ; Joint Instability - etiology ; Joint Instability - surgery ; Ligaments, Articular - diagnostic imaging ; Ligaments, Articular - surgery ; Lunate Bone - diagnostic imaging ; Lunate Bone - surgery ; Male ; Middle Aged ; Pain ; Scaphoid Bone - diagnostic imaging ; Scaphoid Bone - surgery ; scapholunate dissociation ; scapholunate ligament ; scapholunate reconstruction ; Wrist Joint - surgery</subject><ispartof>The Journal of hand surgery (American ed.), 2024-04, Vol.49 (4), p.329-336</ispartof><rights>2024 American Society for Surgery of the Hand</rights><rights>Copyright © 2024 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-1dc84d33c1abf5d1776a4d514f889cae0659a75061f7318225e15acd52d525dd3</citedby><cites>FETCH-LOGICAL-c356t-1dc84d33c1abf5d1776a4d514f889cae0659a75061f7318225e15acd52d525dd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhsa.2023.12.012$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38244024$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haeberle, Heather S.</creatorcontrib><creatorcontrib>DeFrancesco, Christopher J.</creatorcontrib><creatorcontrib>Yang, Brian W.</creatorcontrib><creatorcontrib>Victoria, Christian</creatorcontrib><creatorcontrib>Wolfe, Scott W.</creatorcontrib><title>One-Year Outcomes of the Anatomical Front and Back Reconstruction for Scapholunate Dissociation</title><title>The Journal of hand surgery (American ed.)</title><addtitle>J Hand Surg Am</addtitle><description>Anatomical front and back (ANAFAB) reconstruction addresses the critical volar and dorsal ligaments associated with scapholunate dissociation. We hypothesized that patients with symptomatic, chronic, late-stage scapholunate dissociation would demonstrate improvements in all radiographic parameters and patient-reported outcomes (PROMs) after ANAFAB reconstruction.
From 2018 to 2021, 21 ANAFAB reconstructions performed by a single surgeon were followed prospectively, with 20 patients having a minimum follow-up of 12 months. In total, 17 men and four women were included, with an average age of 49 years. Three patients had modified Garcia-Elias stage 3 disease, eight stage 4, seven stage 5, and three stage 7. ANAFAB reconstruction of intrinsic and extrinsic ligament stabilizers was performed using a hybrid synthetic tape/tendon graft in a transosseous reconstruction. Pre- and postoperative radiographic parameters, grip, pinch strength, the Patient-Rated Wrist Evaluation, PROMIS Upper Extremity Function, and PROMIS Pain Interference outcome measures were compared.
Mean follow-up was 17.9 months (range: 12–38). Radiographic parameters were improved at follow-up, including the following: scapholunate angle (mean 75.3° preoperatively to 69.2°), scapholunate gap (5.9–4.2 mm), dorsal scaphoid translation (1.2–0.2 mm), and radiolunate angle (13.5° to 1.8°). Mean Patient-Rated Wrist Evaluation scores for pain and function decreased from 40.6 before surgery to 10.4. We were unable to detect a significant difference in grip or pinch strength or radioscaphoid angle with the numbers tested. There were two minor complications, and two complications required re-operations, one patient who was converted to a proximal row carpectomy for failure of fixation, and one who required tenolysis/arthrolysis for arthrofibrosis.
At 17.9-month average follow-up, radiographic and patient-reported outcome parameters improved after reconstruction of the critical dorsal and volar ligament stabilizers of the proximal carpal row with the ANAFAB technique.
Therapeutic IV.</description><subject>Anatomical front and back (ANAFAB) reconstruction</subject><subject>Female</subject><subject>Humans</subject><subject>Joint Instability - diagnostic imaging</subject><subject>Joint Instability - etiology</subject><subject>Joint Instability - surgery</subject><subject>Ligaments, Articular - diagnostic imaging</subject><subject>Ligaments, Articular - surgery</subject><subject>Lunate Bone - diagnostic imaging</subject><subject>Lunate Bone - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Scaphoid Bone - diagnostic imaging</subject><subject>Scaphoid Bone - surgery</subject><subject>scapholunate dissociation</subject><subject>scapholunate ligament</subject><subject>scapholunate reconstruction</subject><subject>Wrist Joint - surgery</subject><issn>0363-5023</issn><issn>1531-6564</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM9OGzEQh62qiISUF-ih8rGX3frPerORuNC0UCSkSFAOnIwZzypOd9ep7a3E2_AsPBmOEjhWGmkO8_1-0nyEfOas5IzX3zblZh1NKZiQJRcl4-IDmXIleVGruvpIpkzWslD5PCEnMW4YyympjslENqKqmKim5GE1YHGPJtDVmMD3GKlvaVojPR9M8r0D09GL4IdEzWDpdwN_6A2CH2IKIyTnB9r68PJ8C2a79t2YQ0h_uBg9OLM7fyJHrekinh72jNxd_Py9_FVcry6vlufXBUhVp4JbaCorJXDz2CrL5_PaVFbxqm2aBRhktVqYuWI1b-eSN0Io5MqAVSKPslbOyNd97zb4vyPGpHsXAbvODOjHqMVCLJhqZCUzKvYoBB9jwFZvg-tNeNKc6Z1ZvdE7s3pnVnOhs9kc-nLoHx97tO-RN5UZONsDmL_85zDoCA4HQOsCQtLWu__1vwKvO4re</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Haeberle, Heather S.</creator><creator>DeFrancesco, Christopher J.</creator><creator>Yang, Brian W.</creator><creator>Victoria, Christian</creator><creator>Wolfe, Scott W.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202404</creationdate><title>One-Year Outcomes of the Anatomical Front and Back Reconstruction for Scapholunate Dissociation</title><author>Haeberle, Heather S. ; DeFrancesco, Christopher J. ; Yang, Brian W. ; Victoria, Christian ; Wolfe, Scott W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-1dc84d33c1abf5d1776a4d514f889cae0659a75061f7318225e15acd52d525dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anatomical front and back (ANAFAB) reconstruction</topic><topic>Female</topic><topic>Humans</topic><topic>Joint Instability - diagnostic imaging</topic><topic>Joint Instability - etiology</topic><topic>Joint Instability - surgery</topic><topic>Ligaments, Articular - diagnostic imaging</topic><topic>Ligaments, Articular - surgery</topic><topic>Lunate Bone - diagnostic imaging</topic><topic>Lunate Bone - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pain</topic><topic>Scaphoid Bone - diagnostic imaging</topic><topic>Scaphoid Bone - surgery</topic><topic>scapholunate dissociation</topic><topic>scapholunate ligament</topic><topic>scapholunate reconstruction</topic><topic>Wrist Joint - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haeberle, Heather S.</creatorcontrib><creatorcontrib>DeFrancesco, Christopher J.</creatorcontrib><creatorcontrib>Yang, Brian W.</creatorcontrib><creatorcontrib>Victoria, Christian</creatorcontrib><creatorcontrib>Wolfe, Scott W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of hand surgery (American ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haeberle, Heather S.</au><au>DeFrancesco, Christopher J.</au><au>Yang, Brian W.</au><au>Victoria, Christian</au><au>Wolfe, Scott W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One-Year Outcomes of the Anatomical Front and Back Reconstruction for Scapholunate Dissociation</atitle><jtitle>The Journal of hand surgery (American ed.)</jtitle><addtitle>J Hand Surg Am</addtitle><date>2024-04</date><risdate>2024</risdate><volume>49</volume><issue>4</issue><spage>329</spage><epage>336</epage><pages>329-336</pages><issn>0363-5023</issn><eissn>1531-6564</eissn><abstract>Anatomical front and back (ANAFAB) reconstruction addresses the critical volar and dorsal ligaments associated with scapholunate dissociation. We hypothesized that patients with symptomatic, chronic, late-stage scapholunate dissociation would demonstrate improvements in all radiographic parameters and patient-reported outcomes (PROMs) after ANAFAB reconstruction.
From 2018 to 2021, 21 ANAFAB reconstructions performed by a single surgeon were followed prospectively, with 20 patients having a minimum follow-up of 12 months. In total, 17 men and four women were included, with an average age of 49 years. Three patients had modified Garcia-Elias stage 3 disease, eight stage 4, seven stage 5, and three stage 7. ANAFAB reconstruction of intrinsic and extrinsic ligament stabilizers was performed using a hybrid synthetic tape/tendon graft in a transosseous reconstruction. Pre- and postoperative radiographic parameters, grip, pinch strength, the Patient-Rated Wrist Evaluation, PROMIS Upper Extremity Function, and PROMIS Pain Interference outcome measures were compared.
Mean follow-up was 17.9 months (range: 12–38). Radiographic parameters were improved at follow-up, including the following: scapholunate angle (mean 75.3° preoperatively to 69.2°), scapholunate gap (5.9–4.2 mm), dorsal scaphoid translation (1.2–0.2 mm), and radiolunate angle (13.5° to 1.8°). Mean Patient-Rated Wrist Evaluation scores for pain and function decreased from 40.6 before surgery to 10.4. We were unable to detect a significant difference in grip or pinch strength or radioscaphoid angle with the numbers tested. There were two minor complications, and two complications required re-operations, one patient who was converted to a proximal row carpectomy for failure of fixation, and one who required tenolysis/arthrolysis for arthrofibrosis.
At 17.9-month average follow-up, radiographic and patient-reported outcome parameters improved after reconstruction of the critical dorsal and volar ligament stabilizers of the proximal carpal row with the ANAFAB technique.
Therapeutic IV.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38244024</pmid><doi>10.1016/j.jhsa.2023.12.012</doi><tpages>8</tpages></addata></record> |
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subjects | Anatomical front and back (ANAFAB) reconstruction Female Humans Joint Instability - diagnostic imaging Joint Instability - etiology Joint Instability - surgery Ligaments, Articular - diagnostic imaging Ligaments, Articular - surgery Lunate Bone - diagnostic imaging Lunate Bone - surgery Male Middle Aged Pain Scaphoid Bone - diagnostic imaging Scaphoid Bone - surgery scapholunate dissociation scapholunate ligament scapholunate reconstruction Wrist Joint - surgery |
title | One-Year Outcomes of the Anatomical Front and Back Reconstruction for Scapholunate Dissociation |
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