Carpal Ligament Surgery

Drs Camus and Overstraten have jointly organized the “Wrist Franco-Belgian congress about ligamentary lesions of the wrist before degenerative arthritis”, held in April 2009 in Tournai (Belgium). Dr Camus is in the organizing committee of FESSH.

• PART 1: FUNDAMENTALS.- Anatomy of the carpal ligaments.- Biomechanics of the carpus. Application to the ligamentary lesions.- Clinical examination of the wrist.- Imaging of the carpal traumatic instabilities.- MRI Normal Anatomy and lesion of the extrinsic ligaments.- Definition and classification of carpal instabilities.- Radio-carpal rotary instability.- Vertical Instability of the carpus. Axial dislocation and fracture-dislocation: Review of the literature.- Normal arthroscopy of the wrist.- Wrist arthroscopy to study intrinsic ligaments.- Arthroscopic anatomy and lesions of the extrinsic ligaments.- Dynamic arthroscopic testing: false positives and false negatives.- Arthroscopic criterions to date ligamentary trauma.- PART 2: TREATMENT OF LIGAMENTARY LESIONS.- Management of the wrist sprains by the general practitioner.- Role of the surgeon in raising the awareness of first-line general practitioners.- Management of the constitutional painful mediocarpal laxity.- Arthroscopic debridement and pinning: treatment of peri-lunate unstable recent lesions.- Scapho-lunate ligament suture with arthrotomy.- Treatment of scapho-lunate instability with Blatt's capsulodesis.- Treatment of the chronic lesions of the scapho lunate ligament before arthritis.- Berger's dorsal intercarpal capsulodesis in chronic scapho-lunate instability.- Viegas's dorsal scapho-lunate capsulodesis.- Capsulo Fibrodesis. A new therapeutic option to treat scapho-lunate lesion (Garcia-Elias type 2, 3 and 4) with reducible scaphoid and without arthritis.- Brunelli's tenodesis.- Chronic lunotriquetral ligament injuries: arthrodesis or capsulodesis.- Scapho-lunate reconstruction with a bone-tissue-bone graft.- Reduction and Association of the Scaphoid and Lunate (RASL).- Treatment of chronic, static scapholunate dissociation with the modified Brunelli technique: preliminary results.- Scapho-capitate arthrodesis.- Medico legal aspect of the carpal ligamentary traumatisms.- Socio economic aspect of the carpal ligamentary traumatisms.