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Front, back reconstruction for scapholunate dissociation restores normal alignment

Orthopedics Today features an article written by HSS hand and upper extremity surgeon Scott W. Wolfe, MD, research coordinator, Christian Victoria and fellow Genevieve Rambau, discussing the novel surgical technique of anatomical front and back ligament reconstruction (ANAFAB).

The authors explain ANAFAB restores the critical ligaments that stabilize the scaphoid and collapsed central column of the wrist. It expands on the simplistic approach of addressing the scapholunate gap and combines multiple techniques to address the complex carpal mechanics. Additionally, the transosseous reconstruction of four critical ligaments while preserving the native anatomy is what distinguishes this innovative procedure.

Preliminary study data on a cohort of 14 consecutive patients with average follow-up of 4.25 months demonstrated significant improvement in pain and functional scores of the patient-rated wrist and hand evaluation. The authors conclude, “The ANAFAB procedure, although early in practice, shows promising results. It offers a robust restorative option for patients with acute or chronic scapholunate dissociation, characterized by scapholunate gap, scaphoid rotatory subluxation, DISI and dorsal scaphoid translation. It presents a reconstructive option for patients with early SLAC changes that preserves carpal mechanics and should help to avoid a salvage procedure. Further follow-up is needed to monitor the evolution of this technique.”

Read the full article at Healio.com. This article also appeared in the April 2020 print issue.