Título do Caso / Title of Case

Reconstruction of radioscaphocapitate ligament - treatment of ulnar translation

Resumo / Abstract

Background To measure the life quality, clinical and functional outcomes of a patient
who had undergone reconstruction of radioscaphocapitate ligament (RSL), using
brachioradialis tendon in the treatment of ulnar translation of the carpus
Case Description We present a 36-years-old, man with ulnar translation in his left, non
dominant wrist, after fall accident. Reconstruction of the RSL was performed. One year
later, the patient experienced good evaluation. Wrist flexion was70 degrees, extension
was 60 degrees, radial deviation was 20 degrees, and ulnardeviation was 30 degrees.
Forearm pronation was 85 degrees and supination was 90 degrees and digit motion
was full. DASH score of 5, VAS of 0, and grip strength of 82% compared to the
unaffected side were obtained. Wrist radiographic aspects showed radoiocarpal joint
congruency. The period of fixator treatment was eight weeks. Good stability and joint
congruency of the radiocarpal joint were obtained. Good radiographic, clinical, and
functional results were obtained improving the life quality of that patient.
Literature Review The treatment of ulnar translation is difficult and complicated. There
is no consensus to the overall management. As there is still a lack of long-term results,
the indications for surgery, various surgical options, and the type of the intervention
have been a matter of controversy in the literature. Would radiocarpal joint be stable
when reconstruction of the radioscaphocapitate ligament (RSL), using brachioradialis
tendon was obtained? Is it possible to reduce an ulnar translation with this technique?
Clinical Relevance We would like to suggest the radiocarpal ligament reconstruction to
improve this treatment. We believe this suggestion could maintain wrist more stable
and functional. We agree that the best time to perform the corrections is early. The
authors prefer to reconstruct the RSL then radiocarpal ligament suture or arthrodesis