{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T04:58:21Z","timestamp":1784350701305,"version":"3.55.0"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003There is a paucity of information on minimal surgical intervention for the treatment of chronic dynamic scaphoid instability (CDSI) that will achieve an acceptable mid-term result.<\/jats:p><jats:p>\n          Purpose\u2003We hypothesize that by following a debride-first-then-wait protocol, some patients with CDSI can be treated with arthroscopic debridement alone and avoid a reconstructive procedure.<\/jats:p><jats:p>\n          Patients and Methods\u2003We performed a retrospective, longitudinal study from January 2008 to December 2018 of all patients diagnosed with CDSI and treated with arthroscopic debridement of the scapholunate interosseous ligament. In all cases, a debride-first-then-wait protocol was followed that included a predetermined wait period after arthroscopic debridement, giving the patient a chance to experience possible symptom improvement. This approach integrated the patient's perceived wellness into the decision-making process. All wrists that remained symptomatic or experienced recurrence of symptoms were treated with a reconstructive procedure. The wrists were divided into two groups: arthroscopic debridement only (ADO) and reconstructive procedure (RP).<\/jats:p><jats:p>\n          Results\u2003Seventy-nine wrists (72 patients) of 191 consecutive wrist arthroscopies met the inclusion criteria. The ADO group consisted of 43 wrists (54%). An average of 6.3 years later (range: 2\u201311 years), these patients remained satisfied with the results of the arthroscopic debridement and did not want further treatment. The RP group included 36 wrists (46%) with 91.7% of reconstructive surgeries occurring within 6 months of the arthroscopy. With a mid-term follow-up, 75% of Geissler grade II ligament tears, 48% of grade III tears, and 39% of grade IV tears were successfully treated with arthroscopic debridement alone and avoided a reconstructive surgery.<\/jats:p><jats:p>\n          Conclusion\u2003By adopting a debride-first-then-wait protocol, some patients with CDSI can be treated with a more limited intervention, arthroscopic debridement. In this series, 54% of wrists with CDSI avoided a reconstructive surgery for an average of 6.3 years.<\/jats:p><jats:p>\n          Type of Study \/ Level of Evidence\u2003Case Series, Level IV.<\/jats:p>","DOI":"10.1055\/s-0043-1769934","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T23:01:29Z","timestamp":1692313289000},"page":"310-317","source":"Crossref","is-referenced-by-count":1,"title":["Arthroscopic Debridement for Treatment of Chronic Dynamic Scaphoid Instability"],"prefix":"10.1055","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7786-450X","authenticated-orcid":false,"given":"Cyrus","family":"Steppe","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical School, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7997-3734","authenticated-orcid":false,"given":"Houshang","family":"Seradge","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Seradge Medical, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfred","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Seradge Medical, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3606-7533","authenticated-orcid":false,"given":"Carrie","family":"Seradge","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Seradge Medical, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6947-5333","authenticated-orcid":false,"given":"Kian","family":"Steppe","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Seradge Medical, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9544-2247","authenticated-orcid":false,"given":"Kamran","family":"Steppe","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Seradge Medical, Oklahoma City, Oklahoma"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/0266-7681(93)90199-P","article-title":"Rotary subluxation of the scaphoid: a spectrum of instability","volume":"18","author":"H Watson","year":"1993","journal-title":"J Hand Surg 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