ORIGINAL ARTICLE Treatment of acute scapholunate ligament injuries with bone anchor Marco Rosati • Paolo Parchi • Matilde Cacianti • Andrea Poggetti • Michele Lisanti Received: 23 February 2009 / Accepted: 18 January 2010 / Published online: 19 February 2010 Ó Springer-Verlag 2010 Abstract Scapholunate instability is the most common form of carpal instability. Repair or reconstruction of the scapholunate interosseus ligament is advocated to reduce symptoms, stabilize the scapholunate joint and avoid the progression of carpal degeneration. Aim of this study is to evaluate the results (clinical and radiographic) obtained in 18 patients treated in our department for acute lesions SLIL from 2003 to 2008. Patients were 16 males and 2 females with an average age at the time of the trauma of 33.8 years old (min 17 and max 68 years). The diagnosis of scapho- lunate dissociation relies on a through history and physical examination and imaging studies. Early surgical repair of the torn schapolunate ligament was performed in all the patients. The method used for the treatment of these lesions was open reduction and direct ligament reinsertion through a minianchor MITEK Ò . In our surgical experience in 3 cases we have found a combination between an isolated scaphoid fractures and a scapholunate ligament rupture without carpal dislocation. We reviewed all patients treated with an average follow-up of 32 months (range 9–68 months). The review was carried out both clinically and radiographically (static and dynamic). We achieved 13 excellent results (Mayo score average 94,77), 3 good results (Mayo score average 84), 1 sufficient results (Wrist score 72) and 1 bad result (Wrist score 35). From the radiographic evaluation we found a loss of reduction in the two cases identified clinically as sufficient and bad. One patient after an optimal ligament healing, underwent to a recurrence of the lesion SLIL 2 years from surgery. Open reduction and direct bony fixation of the torn scapholunate ligament using a suture anchor is generally successfull in restoring scapholunate stability and has produced good functional mid-term results. At an average follow up of 32 months excellent or good functional outcomes were reported in 88% of the patients despite a large number of cases with a high energy trauma and other associated injury. The association between an isolated scaphoid fracture and a SLIL lesion is rare but not impossible in presence of a scapholunate instability we recommend the immediate reconstruction of the torn ligament. Keywords Wrist Á Hand Á Scapholunate instability Á Scapholunate ligament Á Scaphoid Á Lunate Á Anchor Introduction Wrist ligament injuries are forms of traumatic instability, insidious and complex, that often involve young people and that are due to sport injuries, work injuries or road acci- dents. These lesions could be isolated, in patients that had a single trauma to the wrist (sport or work injuries), or in association to other lesions in politraumatized patients (road accidents). In acute the diagnosis of these lesions is often difficult because the standard radiographic examination cloud not show any carpal abnomality [1]. Scapholunate instability is the most common form of carpal instability. Repair or reconstruction of the scapho- lunate interosseus ligament is advocated to reduce symp- toms, stabilize the scapholunate joint and avoid the progression of carpal degeneration. M. Rosati Á P. Parchi (&) Á M. Cacianti Á A. Poggetti Á M. Lisanti 1st Orthopaedic Department, University of Pisa, Via Paradisa 2, 56100 Pisa, Italy e-mail: parchip@tiscali.it M. Rosati e-mail: rosati61@virgilio.it 123 Musculoskelet Surg (2010) 94:25–32 DOI 10.1007/s12306-010-0057-8