Triangular fibrocartilage complex (TFCC) dorsal distal repair

In this lecture, Dr. Compson demonstrates the arthroscopic resection of the distal ulna.

In this lecture, Dr. Mantovani presents the principles of the four corner fusion technique.

In this key lecture, Professor Herzberg looks into the techniques for arthroscopic radial styloidectomy.

In this lecture, Dr. van Overstraeten discusses the implication of the extrinsic ligaments to the interosseous stability of the proximal row.

In late chronic scapholunate ligament dissociation, when the arthritis appeared (Slac 2-Slac 3), treatment often involves heavy palliative techniques such as resection of the first row or four bones fusion. We propose a simpler technique of arthroscopic interposition of a polylactide implant (PLA) or palmaris longus tendon, combined with a wide styloidectomy of scaphoid fossa of distal radius and a dorsal capsuloligamentous repair to stabilize the scapholunate dissociation.

In this key lecture, Dr. Caroline Leclercq goes over the complications of wrist arthroscopy with an extensive survey of 10,107 cases.

In this key lecture, Professor Levadoux looks into scapholunate tears, problems, and classifications.

In this key lecture, Dr. Samson focuses on equipment and portals.

The sprain of the scapholunate ligament generates chronic instability, which leads to a chondral change with carpus arthritis. The use of wrist arthroscopy allows the diagnosis of these lesions, even at an early stage, and, sometimes, provides a therapeutic strategy by performing a stable fixation. In some chronic cases when the ligament cannot be repaired but the scapholunate space is reducible (stage 2 to 4 according to Garcia-Elias’ classification), a new arthroscopic dorsal capsuloplasty has been performed in order to avoid a complex reconstruction with common stiffness. The patients were operated on in outpatient settings under regional anesthesia using a pneumatic tourniquet. The capsuloplasty is arthroscopically performed between the dorsal capsule and the dorsal part of the scapholunate ligament, using a PDS suture loop. Scapholunate and scaphocapitate Kirschner wires are placed only at stage 4 after scaphoid reduction. A volar splint was placed for a period of 2 months.

An anatomical and biomechanical study has recently shown that detachment of the scapholunate (SL) ligament from the dorsal capsuloligamentous scapholunate septum (DCSS) and dorsal intercarpal ligament (DIC) worsens scapholunate dissociation. This knowledge has revolutionized the treatment of scapholunate dissociation and formed the basis of the arthroscopic repair of the scapholunate ligament complex. In some large dissociation, we can use a trick, catching a largest part of the dorsal capsule, proximally and distally, in order to help scapholunate reduction when the knot is tightened. Sometimes, the scapholunate ligament is avulsed from the dorsal proximal pole of the scaphoid, and it is necessary to put an anchor at the exact location of the scapholunate attachment into the dorsal scaphoid to allow a dorsal capsuloligamentous repair as for a classical scapholunate tear.