FIFTH EXTENSOR COMPARTMENT ARTERY VASCULARIZED ARTHROPLASTY FOR SCAPHOLUNATE LIGAMENT RECONSTRUCTION...
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Transcript of FIFTH EXTENSOR COMPARTMENT ARTERY VASCULARIZED ARTHROPLASTY FOR SCAPHOLUNATE LIGAMENT RECONSTRUCTION...
FIFTH EXTENSOR COMPARTMENT ARTERY VASCULARIZED ARTHROPLASTY FOR SCAPHOLUNATE LIGAMENT RECONSTRUCTION
F. Quatra, O.Romeo, D. Lowenberg, D. Brooks, F. Stagno D’Alcontres,
M. Colonna, Harry J. Buncke
The Buncke Clinic
San Francisco, California
Department of Plastic Surgery
University of Messina, Italy
Scope of the Problem Lesions to the scapho-lunate ligament
are the most frequent cause of carpal instability and a mayor cause of disability
The Scapho-Lunate Ligament
Current Alternatives Blatt’s capsulodesis Limited Wrist Fusions Tendon Arthroplasties (Primary reinsertion)
Hypothesis
A vascularized graft is expected to heal better than conventional reconstructions with non-vascularized capsule flaps or tendon rods.
Background
Dorsal wrist vascular anatomy
(Bishop, 1995)
Materials and Methods Ten fresh-frozen cadaver limbs Vascular injection Histology for: collagen elastic fiber
5th extensor compartment artery
Constant vessel Caliber 0.6 mm Under the floor of the 5th extensor
compartment
Graft (pedicled fascia flap) 2x1 cm (from roof of 5th compartment*) Pedicle = 4 cm long Pivot point = 1 cm from Radiocarpal
joint Fixation = 2-3 transosseus sutures **
* Extensor digiti minimi fascia
** Mitek anchors?
Vascular Injection
Conclusions Anatomy fairly constant Sizable and strong graft Microscopic structure and collagen
comparable
Let’s try it!
Thank You
Alternative: Posterior Interosseus Artery