Can cast immobilization successfully treat scapholunate dissociation associated with distal radius fractures?

Tang, Jingqun; De, Shi; Gu, Yung Q.; Zhang, Qi G.

doi:10.1016/s0363-5023(96)80007-4

Cited by 50 publications

(25 citation statements)

References 26 publications

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“…High-grade SLIL tear associated with distal radius fractures is not rare [9,16,23,25] and is likely to result in progressive deterioration of wrist function with increasing wrist pain [6,13,30]. Arthroscopy, which is the gold standard for the diagnosis, may not be readily available depending on the condition of the institution, the surgeon, or the insurance, whereas fluoroscopy is widely available, easy to use, and inexpensive.…”

Section: Discussionmentioning

confidence: 99%

“…An isolated, complete tear of the SLIL results in scapholunate instability [19,27,28,34] and in some patients leads to osteoarthritis of the wrist through a specific pattern, the so-called scapholunate advanced collapse wrist [33,34]. Scapholunate interosseous ligament injury, when associated with distal radius fractures, causes progressive deterioration of the intercarpal relationship as well [6,13,30]. Patients with SLIL injury and associated distal radius fractures have worse wrist function than those with distal radius fracture alone [30].…”

Section: Introductionmentioning

confidence: 99%

“…Scapholunate interosseous ligament injury, when associated with distal radius fractures, causes progressive deterioration of the intercarpal relationship as well [6,13,30]. Patients with SLIL injury and associated distal radius fractures have worse wrist function than those with distal radius fracture alone [30]. Grade 3 SLIL injury associated with distal radius fractures results in increased scapholunate joint pain and scapholunate dissociation [6].…”

Section: Introductionmentioning

confidence: 99%

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Fluoroscopic Diagnosis of Scapholunate Interosseous Ligament Injuries in Distal Radius Fractures

Kwon

Baek

2008

Clinical Orthopaedics &Amp; Related Research

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Early diagnosis of scapholunate interosseous ligament tears with distal radius fractures is likely important in treatment and outcome, but identification of these injuries has not been well explored. We asked whether there was a difference in the scapholunate interval between high-grade and low-grade tears of the scapholunate interosseous ligament in distal radius fractures, the best position of the wrists to identify any differences; we also asked what gap width accurately identified high-grade tears on fluoroscopic evaluation. We fluoroscopically evaluated the scapholunate gap in six different wrist positions and then performed arthroscopic examination in 45 distal radius fractures in 44 consecutive patients. The tears were classified as high-grade (Grade 3 or greater) or low-grade (Grade 2 or less) based on arthroscopic findings. We then compared the scapholunate gap measured on fluoroscopic images between the high-grade tear group and the lowgrade tear group and between the different positions of the same wrist. The scapholunate gap was wider in the highgrade tear group than in the low-grade tear group and wider in ulnar deviation than in radial deviation. A 2-mm scapholunate gap appeared the best cutoff point for the fluoroscopic diagnosis. We concluded fluoroscopic examination is a good test for identifying high-grade tears of the scapholunate interosseous ligament in distal radius fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fluoroscopic Diagnosis of Scapholunate Interosseous Ligament Injuries in Distal Radius Fractures

Kwon

Baek

2008

Clinical Orthopaedics &Amp; Related Research

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“…In many cases, the application of the external fixator can make an additional dorsal approach and plating superfluous, thus avoiding extensor tendon problems and the frequent necessity of hardware removal after dorsal plating (see Figures 2 and 3). Numerous authors have reported on associated carpal ligament injuries in distal radius fractures in up to two thirds of acute cases [20,[38][39][40][41]. Two major problems remain in these potentially devastating injuries in the clinical situation.…”

Section: Discussionmentioning

confidence: 99%

Complex Fractures of the Distal Radius

Rikli

Rosenkranz

Regazzoni

2003

European Journal of Trauma

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Objective: Outcome of complex distal radius fractures. Design: Retrospective clinical observation. Setting: Outcome assessment of a clinical series of patients with complex distal radius fractures treated according to a structured, stepwise treatment algorithm. Patients: 17 patients (average age 47 years) with mostly high-energy injuries, 16/17 articular fractures including concomitant carpal injuries, fracture dislocations, extension of the fracture into the diaphysis, and large defects.Intervention: Initial external fixation, followed by soft tissue treatment and further diagnostics and, finally, definitive adapted surgical therapy including combination of external fixation, plates, screws, K-wires, bone graft, and ligament repair. Main Outcome Measurements: DASH, range of motion, radiologic outcome. Results: Average subjective overall performance score (DASH) 16.4 (0-36.7, standard deviation [SD] 11.82, 95% confidence interval [CI] 8.0-23.6), 73% of the patients back to premorbid work and activities. Conclusions: Using a clearly structured, stepwise approach, complex distal radius fractures can be treated with good clinical outcome preserving hand function.

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“…However, in contrast to such a theory, nearly 5% of the patients with distal radial fractures treated with cast immobilization presented with symptomatic SL instability 1 year following injury. Their functional scores were significantly worse than those who did not show signs of SL joint disruption on initial radiographs [20]. It is therefore obviously important to detect associated SL ligament injuries and manage them in an appropriate manner.…”

Section: Introductionmentioning

confidence: 98%

Arthroscopic Management of Scapholunate Dissociation

Lindau

2010

Arthroscopic Management of Distal Radius Fractures

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Can cast immobilization successfully treat scapholunate dissociation associated with distal radius fractures?

Cited by 50 publications

References 26 publications

Fluoroscopic Diagnosis of Scapholunate Interosseous Ligament Injuries in Distal Radius Fractures

Fluoroscopic Diagnosis of Scapholunate Interosseous Ligament Injuries in Distal Radius Fractures

Complex Fractures of the Distal Radius

Arthroscopic Management of Scapholunate Dissociation

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