[Frequency of acute and chronic scapholunate dissociation in distal radius fractures. Different treatment plans].
BACKGROUND
Early diagnosis and appropriate treatment of acute scapholunate dissociation (SLD) is crucial for obtaining a favorable result in fractures of the distal radius. The aim of this study was to determine the incidence of acute SLD in a prospective study and to differentiate this entity from chronic SLD.


METHODS
A total of 120 patients with unilateral distal radius fractures were prospectively evaluated for SLD. Stress radiographs were obtained for all patients on the injured side after fixation of the distal radius fractures. In cases of SLD the unaffected side was examined to rule out chronic, bilateral SLD.


RESULTS
Acute SLD was detected in 13 patients (11%), 11 (9.1%) of whom had stage 3 injury. Chronic SLD with bilateral asymptomatic instability was seen in three patients (2.5%).


CONCLUSIONS
When treating fractures of the distal radius, acute SLD has to be ruled out and to be discriminated from chronic SLD. While acute SLD requires appropriate treatment, immediate treatment of chronic SLD is not indicated.
Schneiders
W
W
Klinik und Poliklinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Carl Gustav Carus, Dresden. schneidersw@gmx.de
Amlang
M
M
Rammelt
S
S
Zwipp
H
H
D000208:Acute Disease; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D005592:Fracture Fixation / Q000379:methods / Q000706:statistics & numerical data; D017102:Fracture Healing; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011379:Prognosis; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*