Hand (New York, N.Y.)
February 15, 2026 · via Europe PMC
Reduction and Association of the Scaphoid and Lunate Versus Internal Brace for Scapholunate Ligament Reconstruction.
Richardson M, Margalit A, Sanchez G, +5 more, Ayalon O.
AI summary — for doctors, generated from the abstract only
RASL screw and internal brace reconstruction gave similar results for unrepairable scapholunate injuries, but each had its own failure mode.
What was studied
Retrospective comparison of 25 patients with complete nonrepairable scapholunate injury treated with RASL screw (14) or suture anchors with internal brace (11), with radiographs, range of motion and qDASH at 6 months or more.
Key findings
- Final SL gap was smaller with RASL (1.5 vs 2.4 mm, P = .03); qDASH was similar (26 vs 31).
- 29% of RASL patients needed further surgery for screw breakage or loosening.
- In the brace group one had complete failure and 36% had osteolysis.
Clinical relevance
Surgeons should weigh hardware-related reoperation against recurrent gapping and osteolysis when choosing a technique.
Who should care
Limitations
Small retrospective series with telephone-based follow-up and unknown clinical significance of the radiographic findings.
Counsel patients about screw removal risk with RASL and gapping/osteolysis with internal brace; neither is clearly superior.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
The purpose of this study is to compare outcomes in patients with isolated unrepairable scapholunate (SL) injuries treated with the reduction and association of the scaphoid and lunate (RASL) screw technique versus suture anchors with an internal brace (IB).
Methods
Patients treated with either the RASL screw or IB technique for a complete, nonrepairable SL injury were identified. Radiographic and clinical data were recorded preoperatively, immediate postoperatively, and at final follow-up. Patients were then contacted via telephone survey, and Quick Disabilities of the Arm, Shoulder, and Hand (qDASH) questionnaire was administered. Patients with less than 6 months of follow-up were excluded.
Results
Twenty-five patients (19 men, 6 women) with an average age of 43 (range = 23-66) years were identified (RASL = 14 and IB = 11). There were no differences between groups in radiographic parameters or range of motion at final follow-up, except for a smaller SL gap at final follow-up in RASL patients (1.5 vs 2.4 mm, P = .03). Four patients in the RASL (29%) group required additional procedures for screw removal secondary to screw breakage (n = 1) or screw migration/loosening (n = 3). One patient in the IB group had complete failure/diastasis postoperatively, and 36% (4/11) of patients had osteolysis at final follow-up. At final follow-up, qDASH was 26 versus 31 in the IB versus RASL groups (P = .79).
Conclusions
Both RASL and IB have similar postoperative outcomes when treating SL injuries. It is important to note complications of screw breakage/loosening associated with RASL and recurrent diastasis/gapping and high rate of osteolysis with IB, although this has an unknown clinical significance.
DOI
10.1177/15589447251414125
PMID
41693149
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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