Nine patients with scapholunate instability underwent treatment at Rikshospitalet Senter for Ortopedi from 1996 to 2001. Four males (mean age 38 years) with dynamic instability were treated with ligament repair; five patients (four males and one female, mean age 31 years) with static instability were treated with the Brunelli procedure, stabilizing the scaphoid with a part of the flexor carpi radialis tendon. Mean follow-up was 8.4 (5.1-11.1) years. The patients were assessed with a questionnaire, a clinical and a radiological evaluation.
All patients reported significant improvement of hand function including grip strength and range of motion after the operation, except for one patient with unchanged function in the dynamic group. No statistically significant differences were found among the groups. Pain scores (VAS) were 1.1 (0.0 – 2.9) and 0.9 (0.0 – 2.3) in the dynamic and static groups, respectively. Mean Quick-DASH and Modified Mayo Wrist Scores were 8.9 and 77.5 in the dynamic group, and 1.1 and 90 in the static group. No carpal instability was encountered. Radiologically, slightly increased malalignment and degenerative osteoarthritis was found in the dynamic group.
Our limited material demonstrates good results with the Brunelli procedure for static scapholunate instability, suggesting the same procedure also for dynamic cases.