Management of Scapholunate Advanced Collapse Pattern of Degenerative Arthritis of the Wrist

Kiefhaber, Thomas R.

doi:10.1016/j.jhsa.2009.06.020

Cited by 36 publications

(24 citation statements)

References 24 publications

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“…Review of the literature indicates a general consensus that the RL joint is spared, or rarely affected, in wrists with SLAC and scaphoid nonunion advanced collapse. [1][2][3][4][5] However, the current study demonstrates the clear presence of RL joint narrowing in a subset of patients with SL dissociation who have not developed RS joint space narrowing. This finding disproves our null hypothesis.…”

Section: Discussionmentioning

confidence: 89%

“…Because of the shape of the scaphoid and the scaphoid fossa of the radius, rotation of the scaphoid is presumed to lead to RS arthrosis. 2,5 Why the scaphoid avoided degeneration in these wrists whereas the lunate did not is the obvious unanswered question. Our review of the radiographs did not provide a clear answer.…”

Section: Discussionmentioning

confidence: 99%

“…5,7 More recent literature has evaluated the roles of the remaining ligamentous attachments to the SL complex (dorsal intercarpal ligament, dorsoradiocarpal ligament, long RL ligament, and short RL ligament) in providing stability. 8,9 These studies focused on SL stability, although information regarding lunate motion, displacement, and stability were not specifically analyzed and discussed.…”

Section: Discussionmentioning

confidence: 99%

“…1 Subsequent authors have continued to espouse the principle that the RL articulation is spared from degenerative change in wrists in which SL dissociation is the presumed incipient cause. [3][4][5] It is accepted, however, that the RL joint is not necessarily spared in cases of ulna positive variance and ulna-lunate impaction. 6 In the everyday treatment of patients for wrist pain, we have observed that some patients have radiographic findings precisely contrary to those described by Watson and Ballet.…”

mentioning

confidence: 99%

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Scapholunate Dissociation With Radiolunate Arthritis Without Radioscaphoid Arthritis

Daher¹,

Leo²

2010

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Scapholunate Dissociation With Radiolunate Arthritis Without Radioscaphoid Arthritis

Daher¹,

Leo²

2010

The Journal of Hand Surgery

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“…18 In 2007, Goubier and Teboul 11 introduced the usage of axial compression screws for fixing the lunate-capitate arthrodesis to achieve the desired stable consolidation. They concluded that their high incidence of complications prior to the introduction of screws was due to the use of Kirschner pins, which Superior functional outcome scores were reported when compared with the four-corner arthrodesis.…”

Section: Discussionmentioning

confidence: 99%

Stage III Advanced Wrist Collapse Treatment Options: A Cadaveric Study

et al. 2016

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Altered wrist biomechanics consequent to a scapholunate dissociation or a scaphoid nonunion accelerates the degeneration of the surrounding articular surfaces and often induces arthritic progression referred to as a scapholunate advanced collapse (SLAC) or scaphoid nonunion advanced collapse (SNAC). 1,2Watson and Ballet described four stages of the arthritic progression of the affected articulations. 2 Stage III progression is determined by radiological evidence of degenerative changes to both the radioscaphoid and the lunate-capitate joint surfaces, and is generally associated with progressive pain and reduced wrist Keywords ► scaphoid nonunion advanced collapse ► arthritis ► advanced collapse ► biomechanics ► wrist AbstractBackground Scapholunate advanced collapse and scaphoid nonunion advanced collapse result in high morbidity and pose significant challenges for active patients. Multiple treatment options have been proposed to yield satisfactory results; however, restoration of physiological wrist motion remains an issue. Questions/Purposes The objective of this study was to compare wrist mobility after four different treatment methods for grade III wrist collapse: (1) no treatment, (2) scaphoidectomy and lunate-capitate arthrodesis, (3) scaphoidectomy, lunate-capitate arthrodesis, and triquetrum-hamate arthrodesis, and (4) scaphoidectomy, lunatecapitate arthrodesis, and triquetrum excision. Methods Four paired (n ¼ 8) fresh-frozen human cadaveric upper limbs were used in this controlled laboratory study. Computed tomography scans were collected at all testing states and measurements were made to evaluate midcarpal joint mobility and alignment. Results A significant decrease in wrist extension was observed for all treatments. Middle column and two-column arthrodesis demonstrated no significant differences for carpal alignment and mobility. No significant differences were observed for triquetrumhamate mobility or wrist extension between the partial and two-column arthrodesis. Triquetrum excision significantly improved ulnar deviation. Conclusion The most important finding of this study was that the one-column arthrodesis has comparable carpal alignment and range of motion to that of bi-column arthrodesis. Clinical Relevance The results of this study suggest that a stage III advanced wrist collapse can be treated by isolated lunate-capitate arthrodesis with scaphoidectomy. Fusion between the remaining carpal bones may not be necessary because the carpal alignment and range of motion of the remaining joints were not significantly different in the present study.

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Post-traumatic Arthritis of the Wrist

Strike

Blazar

2020

Post-Traumatic Arthritis

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Management of Scapholunate Advanced Collapse Pattern of Degenerative Arthritis of the Wrist

Cited by 36 publications

References 24 publications

Scapholunate Dissociation With Radiolunate Arthritis Without Radioscaphoid Arthritis

Scapholunate Dissociation With Radiolunate Arthritis Without Radioscaphoid Arthritis

Stage III Advanced Wrist Collapse Treatment Options: A Cadaveric Study

Post-traumatic Arthritis of the Wrist

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