Wrist Ligamentous Implant

[focus_911]

Hi Folks,
I have recently started lurking around this forum (I'm normally only in the hip injury section) as I have recently started to have to deal with my wrist again.

I might post later my history on here so it makes sense to you folks, but sadly it is just to lengthy for me to type it up and post. Ten years ago (I'm currently 22) suffered from a wrist fracture after a fall which resulted in a very complex TFCC injury. Over the last 5 years I have undergone 5 separate reconstructive surgeries with 2 more to come in trying to care for the initial injury.

My orthopod has mentioned that at this point a wrist fusion is probably the best option for me as the other more conservative alternatives have failed. Given my age he talked to me today about trying out a new procedure where ligaments are implanted into the wrist to replace the damaged ligaments that are currently there.

He said only 10 patients in the states have gone thru the surgery and the second patient in Canada has just undergone the same surgery just 3 weeks ago. My surgeon is the only one to have tried this. He said the results tho very encouraging were questionable as the particular surgeon who did the procedure isnt very well known. He also mentioned to me that because of the lack of documentation on the short and long term results of this new radical procedure, he isnt sure yet what kind of results can be expected.

Anyone heard of this procedure?

I tried looking it up online, but as I dont the name of the doc doing them, or any official names for the procedure itself I have been having a hard time finding info on it. Tho I am very frustrated with the little progress I have been making, at this point I am considering going thru this very foreign procedure in the hopes it might work. My surgeon said that even if it failed, it would not cause issues in doing the fusion is all failed.
Gives me some hope before officially losing all motion.

Any info or help would be greatly appreciated, thanks.

[Zaynah]

hi

I haven't heard of wrist ligament implantation as of yet
It seems that the literature out there suggests a few methods of reconstructing chronic wrist ligament injuries(expecially scapholunate end scaphotriquetral ligamens):
-Dorsal capsulodesis
-Tendon weaves using free tendon grafts
-Scapholunate arthrodesis (fusion)
-Reconstruction using a periosteal flap of the iliac crest
-Bone-ligament-bone autografts
-Bone-retinaculum-bone autografts
-Extensor retinaculum transfer for scapholunate ligament disruption
-Reconstruction using Mitek suture anchors
-Bio-Tenodesis Screw System

I found some informational websites that could be of value to you:
http://www.rcsed.ac.uk/fellows/lvanrensburg/classification/hand/scapholunate_diss.htm
http://www.haukeland.no/metodebokorto/Metodebok_leger/Pdf/biotenodesis.pdf
http://www.eatonhand.com/img/img00085.htm

Good luck

[focus_911]

Thank you, I really appreciate the links.

I know at this point there is very little litterature about ligament/connective tissue transplant. I was informed by my surgeon there is only one physician in the states whos done them and only 10 cases. My surgeon is the only other orthopedic surgeon who has been trying out this new option. He has been very honest with me as to the lack of short and long term results. It is a very experimental procedure.

Thanks again for the links.

[focus_911]

Just found out a more technical term is "mid carpal ligament reconstruction" in case anyone has ever heard of that. Would some enlightenment.

[focus_911]

I had been waiting for a surgical date to get my hip reconstructed and but finally have a surgical date for that so I was able to also get a date for my wrist.

I will be going in August 13th.

Will try to keep updates up.