Misdiagnosed and maltreated wrist ligament injuries (scapholunate [SL], lunotriquetral, and triangular fibrocartilage complex [TFCC]) filed to the Swedish National Patient Insurance Company (LÖF ["regionernas ömsesidiga försäkringsbolag"]) 2011 to 2018 were analyzed in terms of complications and costs for society. All filed claims are database registered. The database was assessed in June 2019 through injury International Classification of Diseases 10th Revision-SWE diagnoses. Demographics, reasons for avoidance, type of complication, and costs were assessed. Trend analysis was also used to compare the numbers of filed claims of wrist ligament injuries and total injuries. The mean age of the 231 extracted patients was 38 years. Females represented 57%. Ninety-eight (42%) of the claims were judged as avoidable, in accordance with the 40% approved patient injuries of all notified injuries during the same time period. Isolated injuries to the TFCC and SL ligament were the most common (n = 185, 80%). One to seven secondary surgical procedures/patient were needed to treat the condition. Sixty-nine (30%) of the 231 patients had medical invalidity due to the avoidable complication(s). Disability was more severe if more than one surgical procedure was needed. There was a significant trend toward decreasing numbers of filed claims for wrist ligament injuries ( = 0.002) over time, in contrast to the total number of filed claims to LÖF, which has increased by an average of 6% annually for a cumulative increase of 60% from 2011 to 2018. The total cost for misdiagnosed and mistreated wrist ligament injuries in Sweden from 2011 to 2018 was €2,203,467, and costly for both the patients and society at large. Level III, therapeutic.
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http://dx.doi.org/10.1055/s-0043-1776342 | DOI Listing |
Bone Jt Open
March 2025
Department of Orthopaedics and Sports Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Aims: Diagnostic wrist arthroscopy is considered the gold standard for evaluating wrist joint complaints. Although this tool is often used to diagnose and stage scapholunate ligament (SLL) lesions, reports about the possible findings and their clinical relevance are scarce. Therefore, this study describes the patient characteristics, arthroscopic findings, and treatment of patients who underwent diagnostic arthroscopy for suspected SLL injury.
View Article and Find Full Text PDFTrauma Case Rep
February 2025
Department of Orthopedics, PGIMER, Chandigarh, India.
Case: We present a case of 20-year-old male with an isolated scaphoid dislocation and scapholunate ligament injury of the wrist, diagnosed and repaired in an acute setting with k wires and suture anchor augmentation. At 1 year follow up patient complained of no pain and returned to work without any limitations, with no signs of avascular necrosis of the scaphoid on imaging.
Conclusion: In acute trauma injuries involving multiple joints, these subtle injuries are often missed, which ultimately leads to degenerative changes.
Clin Sports Med
April 2025
Department of Orthopaedics, Cedars-Sinai Medical Center, 444 South San Vicente Boulevard, Suite 603, Los Angeles, CA 90048, USA. Electronic address:
Pitching, catching, and base-running may predispose professional baseball players to injury-particularly in the hand and wrist. In this study, we outline the diagnosis, management, and rehabilitation of commonly encountered injuries among these high-level athletes. Wrist injuries discussed include hook of hamate fractures, extensor carpi ulnaris tendon disorders, scapholunate instability, and triangular fibrocartilage complex tears.
View Article and Find Full Text PDFJ Hand Surg Glob Online
January 2025
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Pediatric patients can pose challenges with regard to both diagnosis and obtaining an accurate history and physical examination, as well as in treatment strategies, as options become limited when physes remain open. This case report examines a 12-year-old boy who sustained a radial neck fracture after a ground-level fall. Although his elbow injury was treated appropriately, he developed wrist pain that progressed to static volar intercalated segmental instability deformity in the context of a carpal instability nondissociative wrist.
View Article and Find Full Text PDFScapholunate instability can result in debilitating pain, dysfunction, and secondary arthritis. Diagnosis is primarily based on a combination of clinical and radiological parameters. However, wrist arthroscopy is regarded as the gold standard for definitive confirmation to identify the extent of a scapholunate instability, with specific attention to the integrity of the extrinsic ligamentous system, which is probably more important than the intrinsic ligament.
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