title: Reduction and association of the scaphoid and lunate procedure: short-term clinical and radiographic outcomes.
abstract: OBJECTIVE
  To evaluate the success of reduction and association of the scaphoid and lunate with a fibrous union in an effort to evaluate the technique's validity and reproducibility.
  
  
  METHODS
  A retrospective review was performed on 7 patients (8 wrists) with an average follow-up of 38 months. Static and grip radiographs were examined in the preoperative, immediate postoperative, and final follow-up settings to evaluate scapholunate (SL) diastasis, SL angle, hardware position, and complications. At final follow-up, grip strength and wrist range of motion were recorded, and patients completed the Disabilities of the Arm, Shoulder, and Hand and the Patient-Rated Wrist Evaluation outcome questionnaires.
  
  
  RESULTS
  Radiographic success, defined by maintenance of corrected SL diastasis, absence of dorsal intercalated segmental instability, and no progression of SL advanced collapse was achieved in 3 of the 8 wrists. One wrist developed radioscaphoid arthritis. No patients required a salvage procedure. Despite the loss of reduction that occurred in all patients, the patients' disability remained minimal as detected by the scores on the outcome measures.
  
  
  CONCLUSIONS
  The procedure was ineffective in providing stability about the SL interval. With a majority of patients experiencing early radiographic failure of the procedure in the short term, our experience suggests that the reduction and association of the scaphoid and lunate procedure should be abandoned despite the relatively low outcomes measures scores, which may be reflective of the short follow-up duration for this series.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedics, University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: TimothyLarson@texashealth.org.
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Larson
authors.affiliation: Department of Orthopaedics, University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Stern
mesh_terms: D000328:Adult; D001174:Arthrodesis; D001863:Bone Screws; D050824:Carpal Joints / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011859:Radiography; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D055815:Young Adult
keywords: RASL; Scapholunate; carpal instability