Scapholunate Instability
نویسنده
چکیده
Scapholunate instability is the most common carpal instability. The evaluation and treatment of scapholunate instability is controversial and the outcome unpredictable. This article will review the pertinent ligamentous anatomy of the wrist and carpal kinematics. There will be a discussion of the clinical presentation, examination, and diagnostic testing of the patient suspected of having scapholunate instability. The treatment options and indications, including repair and reconstructive and salvage procedures, will be reviewed.
منابع مشابه
Proposition of a new classification for scapholunate instability.
UNLABELLED Scapholunate (SL) instability is the most common pattern of instabilities in the wrist. If untreated or undiagnosed, it may lead to degenerative changes with SLAC (scapholunate advanced collapse) wrist. There are a few of of well-known SL instability classifications. The one that takes into account a dynamic or static nature of SL instability is the most accepted and used. The arthro...
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A consecutive series of 100 cases of wrist injury, other than those referred with a radial fracture, have been reviewed to determine the incidence of acute scapholunate instability; a "clenched fist" radiograph was used in addition to the routine scaphoid views. Of 19 patients with an increase in the scapholunate gap, five were eventually considered to have significant scapholunate instability,...
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Seven patients with chronic scapholunate instability (Geissler grade 2-4) were treated by percutaneous placement of screws across the scapholunate joint after arthroscopic debridement of the remnants of the scapholunate ligament. In all seven cases, the screw caused partial destruction of the lunate and/or scaphoid requiring screw removal within 6 months. We no longer perform this procedure.
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Injuries to the scapholunate joint [SLJ] are the most frequent cause of carpal instability and account for a considerable degree of wrist dysfunction. It is insufficient to cause abnormal carpal posture or collapse on static radiographs, an isolated injury to the scapholunate interosseous ligament may cause progression to abnormal joint mechanics, cartilage wear, and degenerative changes. Inter...
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