Analysis of Tenodesis Techiques for treatment of Scapholunate Instability using the Finite Element method

Chronic Scapholunate ligament (SL) injuries are difficult to treat and can lead to wrist dysfunction. Whilst several tendon reconstruction techniques have been employed in the management of SL instability, SL gap reappearance after surgery has been reported. Using finite element model and cadaveric study data we investigated the performance of the Corella, schapolunate axis (SLAM) and modified Brunelli tenodesis (MBT) techniques. Virtual tenodesis surgery was undertaken in 3D finite element (FE) models to obtain the scapholunate (SL) gap and angle resulting from the three reconstruction techniques. The Corella technique was found to achieve the SL gap and angle closest to the intact, restoring SL gap and angle to within 5.6% and 0.6% respectively. The MBT method resulted in an SL gap least close to the intact. The results of our study indicate that the contribution of volar SLIL to scapholunate stability could be important.

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