Correlation between the scapholunate space and clinical evolution in distal radius fractures

Abstract

Introduction. Scapholunate instability is the most frequent carpal instability. It covers a wide spectrum of injuries and is usually associated with distal radius fractures. Objective. The aim of the study was to correlate the clinical evolution in patients with distal radius fractures with and without the opening of the scapholunate space. Methods. An observational, prospective, and comparative study was carried out at our institution. We included patients over 18 years of age with a diagnosis of distal radius fracture. The scapholunate space was measured, and pain and wrist functionality were evaluated after removing the cast and nails using the DASH and PRWE scales. Results. A total of 90 patients were included in the study. The mean age of the patients was 52.7 ± 16.8 years. About 56.7% were women, and 43.3% were men. A space < 2.5 mm was found in 34 (37.8%) and < 2 mm in 51 (56.7%). We found a decrease in scores over 8 weeks that was less than the baseline scores in patient groups with both an open and closed scapholunate space, indicating a better clinical outcome. We found a similar clinical course at 8 weeks in both groups. Conclusions. Patients with distal radius fractures present a favorable clinical evolution over the course of 8 weeks after the removal of the nails and plaster used to immobilize the fracture. The opening of the scapholunate space does not interfere with the prognosis of the patients.