Can splinting and early mobilization in the dart-throwers plane of motion improve functional outcomes and reduce postoperative complications in people after scapho-lunate ligament repairs? (Pilot Study)

When the surgeon decides it is safe to remove the post-operative plaster cast (usually at 6 weeks, but can vary from 4-10 weeks depending on complexity of surgery) participants are randomised to 2 groups: intervention and control. For the intervention group, a 2-part hinged splint will be fabricated which allows wrist motion in the Dart Throwing Plane. This is the normal motion the wrist would go through when thowing a dart or using a hammer, and involves a comination side-to-side and flexion / extension. The splint is to be removed only for hygiene and for exercise program every 2 hours during the day for the first 4 weeks, beginning with: - gentle wrist movement within patient's pain limits: wrist in mid-prone extension and flexion (no flexion beyond 30 degrees); wrist in supination ulnar and radial deviation; tenodesis exercise; dart-throw motion. These will be taught in the clinic, with correction of technique if necessary, then the participant continues the program at home. Participants are reviewed weekly to check progress until week 6. After first week: - add gentle isometric activation of flexor carpi radialis After third week: - add gentle isometric activation of: flexor carpi ulnaris, abductor pollicis longus, extensor carpi radialis longus and brevis. After 4 weeks, the splint can be removed for light activity (e.g. dressing, grooming, eating) but should be worn if pain flares or when doing more strenuous tasks. It should cease completely by week 6.