Arthroscopically diagnosed scapholunate ligament injuries associated with distal radial fractures: a 13- to 15-year follow-up.
OBJECTIVE
To evaluate the natural history of untreated complete or partial scapholunate (SL) ligament tears associated with displaced distal radius fractures.


METHODS
Between 1995 and 1997, 51 consecutive patients aged < 60 years with displaced distal radius fractures were examined arthroscopically to assess for concomitant soft tissue injuries. Thirty-two of 51 patients had an SL ligament tear, 10 had a complete tear (Lindau grade 3), and 22 had a partial tear (Lindau grades 1 and 2). Thirty-two patients had AO type-C fractures, 3 had type-B fractures, and 16 had type-A fractures. In 2010, 47 of the 51 patients were still alive, and they were invited for an interview, clinical examination, and radiography.


RESULTS
Thirty-eight of the 51 original patients participated in the long-term follow-up. Mean grip strength was 83% relative to the contralateral hand in patients with a complete tear, as compared with 92% in patients with partial or no SL tears (nonsignificant). Median Disabilities of the Arm, Shoulder, and Hand questionnaire score was 2 (range, 0‒55) for complete SL tears, compared with 9 (range, 0‒70) for the others (nonsignificant). No differences were found regarding visual analog scale pain or wrist motion/forearm rotation. None of the patients developed a static SL dissociation or a SL advanced collapse wrist.


CONCLUSIONS
No major differences were found in the subjective, objective, or radiographic outcome after a complete (grade 3) or partial (grade 1 or 2) SL untreated tear associated with displaced distal radius fracture. It should be noted that none of the patients had a grade 4 SL tear, which may have a different outcome.


METHODS
Prognostic II.
Department of Hand Surgery, Clinical Sciences, Lund University and Skåne University Hospital, Sweden. Electronic address: anteort@gmail.com.
Ante
A
Mrkonjic
Pulvertaft Hand Centre, Derby, United Kingdom.
Tommy
T
Lindau
Center of Medical Imaging and Physiology, Clinical Sciences, Lund University and Skåne University Hospital, Sweden.
Mats
M
Geijer
Department of Orthopedics, Clinical Sciences, Lund University and Skåne University Hospital, Sweden.
Magnus
M
Tägil
D000328:Adult; D001182:Arthroscopy; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006230:Hand Injuries / Q000175:diagnosis*; D018737:Hand Strength; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries*; D012667:Lunate Bone / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D011885:Radius Fractures / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D021361:Scaphoid Bone / Q000000981:diagnostic imaging; D064232:Visual Analog Scale; D055815:Young Adult
Osteoarthritis; radius fracture; scapholunate ligament