A 28-year-old female patient sustains an acute scapholunate injury after a fall from a horse. Intra-operatively, it is discovered that the ligament has undergone a midsubstance rupture and is not amenable to repair. Which of the following is the best next step in treatment?
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- Percutaneous pinning of the scapholunate and midcarpal joints Pinning without ligament reconstruction is unlikely to restore carpal stability.
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- Scapholunate arthrodesis Typically, arthrodesis is a salvage procedure and would not be performed unless other treatment options had failed.
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- Proximal row carpectomy Typically, a proximal row carpectomy is used as a salvage procedure in patients over 35 years of age.
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- Acute ligamentous reconstruction If the ligament is not amenable to repair, a reconstruction would be indicated.