Modified Arthroscopic Volar Scapholunate Capsuloligamentous Repair in Chronic Severe but Reducible Volar Scapholunate Instability

The scapholunate complex is composed of the intrinsic scapholunate ligament and the surrounding extrinsic ligamentous system on the dorsal and volar sides of the wrist. In chronic severe but reducible scapholunate instability (European Wrist Arthroscopy Society stage 4) without arthritis, intrinsic as well as extrinsic ligamentous stabilization becomes highly insufficient and lax. A modification of existing arthroscopic volar capsuloligamentous repair techniques is presented to specifically tighten the volar intrinsic scapholunate ligament in combination with the volar extrinsic scapholunate ligaments, without bone tunnels, bone anchors, or tendon grafts. This technique may be a useful complement to a dorsal extrinsic capsuloligamentous plication in high-grade scapholunate instability.