Scapholunate advanced collapse wrist salvage.
Patients with scapholunate advanced collapse (SLAC) wrist do not have to undergo total wrist arthrodesis; the SLAC pattern spares the radiolunate articulation, providing a basis for salvage. We report the results of 100 cases in which a technique comprised of scaphoid excision and limited wrist arthrodesis was used. The average followup period of 44 months revealed excellent functional status and a high rate of patient satisfaction. The majority of employed patients were able to return to their original jobs, and many chose to resume wrist-related recreational activities. Pain relief was good to excellent in most cases. Extension/flexion averaged 72 degrees (53% of a normal opposite wrist), radioulnar deviation 37 degrees (59%), and grip strength 80% of the opposite side. X-ray films revealed only two instances of radiolunate destruction, both in conjunction with ulnar translation of the carpus. The other 98 patients demonstrated a well-preserved radiolunate joint regardless of followup interval. Complications were few. Nonunion occurred in three cases. A dorsal impingement of the capitate and radius (12%) was felt to be technique-related and avoidable by careful capitolunate alignment.
Ashmead
D
D
Connecticut Combined Hand Surgery Service, Hartford Hospital, University of Connecticut, Newington Children's Hospital.
Watson
H K
HK
Damon
C
C
Herber
S
S
Paly
W
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*