2026 ASSH On Demand CME Webinar: Intercarpal Ligament Injuries: Secrets to Success-Recording

Video Transcription

Video Summary

This ASSH webinar, "Intercarpal Ligament Injuries: Secret to Success," gathered international wrist experts to discuss diagnosis, treatment, and innovations for scapholunate (SL) and lunotriquetral (LT) ligament injuries. Dr. Nina Hsu highlighted the challenges in diagnosing these injuries given nonspecific symptoms and imperfect physical exams, emphasizing imaging modalities like provocative radiographs, MRI, and advanced dynamic imaging techniques, with wrist arthroscopy remaining the diagnostic gold standard. Dr. Sanj Kakkar elaborated on arthroscopic techniques, particularly capsulodesis, to restore dorsal and volar ligament stability. Using suture-based tethers mimicking secondary stabilizers (e.g., dorsal intercarpal ligament), he demonstrated biological repair methods enhancing wrist stability while minimizing invasiveness.<br /><br />Dr. Eugene Eck presented open anatomic C-shaped repairs that restore both volar and dorsal SL ligaments using double-loaded suture anchors and K-wire stabilization. Though requiring a larger incision, this technique offers strong repair and quicker rehabilitation. Dr. Spencer Chambers shared insights on arthroscopic 360° SL ligament reconstruction using tendon grafts to stabilize the joint and secondary ligaments while preserving soft tissue vascularity. Dr. Steven Shin discussed open reconstructions using suture tape augmentation without tendon grafts, citing advantages in strength and reduced surgery time, but acknowledging failures due to anchor loosening and osteolysis.<br /><br />For LT injuries, Drs. Michelle Carlson and Ezekiel Zeidenberg detailed arthroscopic-assisted and mini-open anchor-based repairs focusing on restoring stability without extensive surgery, with emphasis on individualized treatment depending on injury severity and arthritic changes. Zeidenberg cautioned about bone tunnel risks for LT reconstructions and advocated for capsule-ligament repairs augmented with temporary fixation.<br /><br />The panel discussed managing failures, noting the importance of identifying reducibility and addressing both primary and secondary stabilizers. Consensus emphasized that no single technique is definitive, but evolving arthroscopic and open methods combining anatomical repair and reconstruction offer promising paths forward. The webinar concluded that while a "secret to success" remains elusive, integration of advances in imaging, biologic repair, and minimally invasive reconstruction is shaping improved outcomes for complex intercarpal ligament injuries.

Keywords

Intercarpal ligament injuries

Scapholunate ligament

Lunotriquetral ligament

Wrist arthroscopy

Capsulodesis

Suture-based tethers

Open anatomic C-shaped repair

Suture anchors

K-wire stabilization

Tendon graft reconstruction

Suture tape augmentation

Arthroscopic-assisted repair

Minimally invasive wrist surgery