TechniqueDorsal Intercarpal Ligament Preserving Arthrotomy and Capsulodesis for Scapholunate DissociationOmokawa, Shohei MD, PhD*; Ono, Hiroshi MD, PhD†; Suzuki, Daisuke MD†; Shimizu, Takamasa MD, PhD‡; Kawamura, Kenji MD, PhD‡; Tanaka, Yasuhito MD, PhD‡Author Information Departments of *Hand Surgery ‡Orthopedic Surgery, Nara Medical University, Kashihara †Department of Orthopedic Surgery, Hand and Trauma Center, Nishi-Nara Central Hospital, Nara, Nara Prefecture, Japan Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Shohei Omokawa, MD, PhD, Department of Hand Surgery, Nara Medical University, 840 Shijo-cho, Kashihara 634-8521, Nara Prefecture, Japan. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: March 2020 - Volume 24 - Issue 1 - p 43-46 doi: 10.1097/BTH.0000000000000273 Buy SDC Metrics Abstract Carpal instability secondary to scapholunate (SL) ligament tears can lead to a significant disability of the wrist. Different surgical procedures have been proposed to treat SL instability. A variety of dorsal capsulodesis techniques tethering the scaphoid have been used in patients with SL dissociation. We report a novel technique of modified dorsal intercarpal ligament (DICL) capsulodesis for the treatment of SL dissociation. The surgical indication for this procedure is complete SL ligament tear with a reducible carpal malalignment and no secondary osteoarthritis. This procedure is indicated when the remnant of torn ligament in the dorsal SL interosseous space is available for repair. First, carpal malalignment is corrected and the scaphoid and the lunate are temporarily fixed with a transosseous screw or Kirschner wires. Using a dorsal approach, the DICL is then exposed, which originates from the triquetrum and attaches to the scaphoid, trapezium, and trapezoid. The distal and proximal borders of the ligament are identified and elevated without detaching the attachment sites. The DICL is transferred proximally to reinforce the dorsal SL interosseous ligament. The wrist joint is immobilized for 3 weeks postoperatively, and dart-throwing motion is permitted until temporary SL fixation is removed at 2 to 3 months after surgery. A wrist brace is recommended until 3 to 6 months after the first surgery depending on the patient’s occupation and sports activity. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.