The aim of this study was to identify anatomic risk factors for scapholunate dissociation. On a PA view of the wrist, in zero position, the scaphoid and lunate diameter and height, lunate tilting angle, lunate uncovering index, lunate fossa inclination, radial inclination and ulnar variance were measured; on a lateral view the scapholunate angle and palmar tilting angle were measured. In a control group (N = 126) first left to right were compared which showed low correlations for radial inclination (r = 0.26), palmar tilt (r = 0.60) and ulnar variance (r = 0.68). These parameters were then measured on the affected hand in the study group, since they are not influenced by the dissociation, and no arthritic changes were seen. A statistically significant difference was found for a low lunate fossa inclination (p = 0.0001) and a low radial inclination (p = 0.0002). These factors may predispose to scapholunate dissociation.
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J Hand Surg Eur Vol
January 2025
Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
Articular malalignment and ulnocarpal impaction can progress to osteoarthritis in the wrist. This may be triggered by tears of the scapholunate ligament (rarely the lunotriquetral ligament) or the foveal lamina of the triangular fibrocartilage complex. In the pre-degenerative stages, radiographic findings are inconclusive, and symptoms may be absent or discrete.
View Article and Find Full Text PDFJ Hand Surg Glob Online
November 2024
Department of Orthopedic Surgery, Crystal Clinic, Akron, OH.
This surgical technique article describes the anatomic C scapholunate reconstruction technique. It is indicated for complete acute or chronic scapholunate ligament dissociation. The technique addresses severe scapholunate interval gapping, ulnar translocation of the lunate, and rotational/dorsal intercalated segment instability.
View Article and Find Full Text PDFJ Hand Surg Am
December 2024
Brisbane Hand and Upper Limb Research Institute, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Debate persists about the optimal surgical management of scapholunate dissociation. Many contemporary techniques address both the injured scapholunate ligament as well as the capsuloligamentous stabilizers necessary to prevent carpal instability and collapse. Here, we present a technique to reinforce or plicate the long radiolunate ligament, a critical stabilizer to the carpus.
View Article and Find Full Text PDFJ Hand Surg Am
November 2024
Department of Hand Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Mehiläinen Helsinki Hospital, Helsinki, Finland.
Purpose: Scapholunate dissociation frequently results in malalignment and scapholunate advanced collapse (SLAC). Previous analyses have relied on visual observations of carpal angles among the scaphoid, lunate, and capitate on lateral radiographs. However, the 3-dimensional carpal alignment during SLAC progression remains unclear.
View Article and Find Full Text PDFCureus
October 2024
Department of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, JPN.
Infections associated with percutaneous pinning of the fingers occur in a certain percentage of cases; however, osteomyelitis rarely leads to more severe suppurative arthritis of the hand. A 26-year-old woman presented with scapholunate dissociation and underwent percutaneous pinning. Although some signs of infection were found around the pin site at five weeks, the pins were removed seven weeks postoperatively.
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