Article

Capitolunate instability is a form of midcarpal
instability. If conservative management is unsuccessful, surgical reconstruction
is often indicated. However,
the literature is limited regarding postoperative
management after reconstruction. Often patients are immobilized for a 6- to
12-week period, which can produce secondary complications, including wrist
stiffness, tendon adherence, and muscle atrophy. The purpose of the case report
was to demonstrate that controlled early mobilization may be implemented
postoperatively after dorsal capsulodesis procedures to correct capitolunate
instability. This early mobilization may prevent secondary complications, which
can be associated with lengthy immobilization periods. A 27-year-old female
underwent a dorsal capsulodesis procedure to correct capitolunate instability.
The intraoperative findings of the reconstruction and tension on the capsulodesis
procedure were communicated to the therapist by the surgeon. This close
communication allowed the therapist to institute early controlled mobilization
immediately postoperatively using a hinged wrist splint. The patient was followed
by our unit for 13 years. Early controlled mobilization using a hinged wrist
splint may have maximized the subject's recovery, with no secondary
complications. At 13-year follow-up, fluoroscopic and radiographic examination
was normal, and no symptoms of pain or instability had reoccurred. In conclusion,
early controlled mobilization using a hinged wrist splint may optimize the
recovery period while retaining the desired arc of motion that is set intraoperatively.
LEVEL OF EVIDENCE: 4.
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Langue : ANGLAIS