Scapholunate advanced collapse
Updates to Article Attributes
Scapholunate advanced collapse (SLAC) refers to a pattern of wrist malalignment that has been attributed to post-traumatic or spontaneous osteoarthritis of the wrist.
Pathology
It is often a consequence of non union a no-united scaphoid fracture or untreated scapholunate dissociation and rotatory subluxation of the scaphoid bone which resulting in radioscaphoid malalignment, progressive chondromalacia, and osteoarthritis.
Its features, however, also have been observed in patients with idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease.
Radiographic features
PatternThe pattern is that of a progressive osteoarthritis affecting initially the articulation between the radial styloid and the scaphoid. In later stages of the disease, osteoarthritis affects the whole radioscaphoid articulation, then the articulation between lunate and capitate. Finally it may involve other intercarpal joints. In addition there is widening of the space between scaphoid and lunate as well as proximal migration of the scaphoid and the capitate3.
Watson staging is often used by hand surgeons8:
-
I: osteoarthritis of the articulation between the radial styloid and the scaphoid
. - II: osteoarthritis involving the whole radioscaphoid articulation
- III: osteoarthritis of the radioscaphoid and capitolunate articulations
-
IV: osteoarthritis of the radiocarpal and intercarpal articulations +/-
DRUJdistal radioulnar joint (DRUJ)
* noteNote that the radiolunate joint is almost preserved until very last stages of the disease.
CT
Sagittal reformatted images from multidetector CT arthrographic data are particularly useful in demonstrating abnormal angulations of the scaphoid and lunate bones (increased scapholunate angle and dorsal or volar intercalated segment instability deformity), radioscaphoid incongruity, cartilage loss, and subchondral bone degenerative changes.
Treatment and prognosis
Surgical treatment for SLAC wrist includes 4four-corner arthrodesis, capitolunate arthrodesis, complete wrist arthrodesis, scaphoidectomy, proximal row carpectomy (PRC), denervation, and radial styloidectomy 2,5-6, 5, 6.
More content required on prognosis
-<p><strong>Scapholunate advanced collapse (SLAC) </strong>refers to a pattern of wrist malalignment that has been attributed to post-traumatic or spontaneous osteoarthritis of the wrist.</p><h4>Pathology</h4><p>It is often a consequence of non union scaphoid fracture or untreated <a href="/articles/scapholunate-dissociation">scapholunate dissociation</a> and rotatory subluxation of the scaphoid bone which resulting in radioscaphoid malalignment, progressive chondromalacia, and osteoarthritis.</p><p>Its features, however, also have been observed in patients with <a href="/articles/calcium-pyrophosphate-dihydrate-deposition-disease">idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease</a>.</p><h4>Radiographic features</h4><p>Pattern is that of a progressive osteoarthritis affecting initially the articulation between the radial styloid and the scaphoid. In later stages of the disease, osteoarthritis affects the whole radioscaphoid articulation, then the articulation between lunate and capitate. Finally it may involve other intercarpal joints. In addition there is widening of the space between scaphoid and lunate as well as proximal migration of the scaphoid and the capitate<sup>3</sup>.</p><p><strong>Watson </strong>staging is often used by hand surgeons<sup>8</sup>: <br><strong>I</strong>: osteoarthritis of the articulation between the radial styloid and the scaphoid.<br><strong>II: </strong>osteoarthritis involving the whole radioscaphoid articulation<br><strong>III:</strong> osteoarthritis of the radioscaphoid and capitolunate articulations</p><p><strong>IV: </strong>osteoarthritis of the radiocarpal and intercarpal articulations +/- DRUJ</p><p>* note that radiolunate joint is almost preserved until very last stages of the disease.</p><h5>CT</h5><p>Sagittal reformatted images from multidetector CT arthrographic data are particularly useful in demonstrating abnormal angulations of the scaphoid and lunate bones (increased scapholunate angle and dorsal or volar intercalated segment instability deformity), radioscaphoid incongruity, cartilage loss, and subchondral bone degenerative changes</p><h4>Treatment and prognosis</h4><p>Surgical treatment for SLAC wrist includes 4-corner arthrodesis, capitolunate arthrodesis, complete wrist arthrodesis, proximal row carpectomy (PRC), denervation, and radial styloidectomy <sup>2,5-6</sup>.</p><p>More content required on prognosis</p>- +<p><strong>Scapholunate advanced collapse (SLAC) </strong>refers to a pattern of wrist malalignment that has been attributed to post-traumatic or spontaneous <a href="/articles/osteoarthritis">osteoarthritis</a> of the wrist.</p><h4>Pathology</h4><p>It is often a consequence of a no-united <a href="/articles/scaphoid-fracture">scaphoid fracture</a> or untreated <a href="/articles/scapholunate-dissociation">scapholunate dissociation</a> and rotatory subluxation of the scaphoid bone which resulting in radioscaphoid malalignment, progressive chondromalacia, and osteoarthritis.</p><p>Its features, however, also have been observed in patients with <a href="/articles/calcium-pyrophosphate-dihydrate-deposition-disease">idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease</a>.</p><h4>Radiographic features</h4><p>The pattern is that of a progressive osteoarthritis affecting initially the articulation between the radial styloid and the scaphoid. In later stages of the disease, osteoarthritis affects the whole radioscaphoid articulation, then the articulation between <a href="/articles/lunate">lunate</a> and <a href="/articles/capitate">capitate</a>. Finally it may involve other intercarpal joints. In addition there is widening of the space between <a href="/articles/scaphoid">scaphoid</a> and lunate as well as proximal migration of the scaphoid and the capitate <sup>3</sup>.</p><p><strong>Watson </strong>staging is often used by hand surgeons <sup>8</sup>: </p><ul>
- +<li>
- +<strong>I</strong>: osteoarthritis of the articulation between the radial styloid and the scaphoid</li>
- +<li>
- +<strong>II: </strong>osteoarthritis involving the whole radioscaphoid articulation</li>
- +<li>
- +<strong>III:</strong> osteoarthritis of the radioscaphoid and capitolunate articulations</li>
- +<li>
- +<strong>IV: </strong>osteoarthritis of the radiocarpal and intercarpal articulations +/- distal radioulnar joint (DRUJ)</li>
- +</ul><p>Note that the radiolunate joint is almost preserved until very last stages of the disease.</p><h5>CT</h5><p>Sagittal reformatted images from multidetector CT arthrographic data are particularly useful in demonstrating abnormal angulations of the scaphoid and lunate bones (increased scapholunate angle and dorsal or volar intercalated segment instability deformity), radioscaphoid incongruity, cartilage loss, and subchondral bone degenerative changes.</p><h4>Treatment and prognosis</h4><p>Surgical treatment for SLAC wrist includes four-corner arthrodesis, capitolunate arthrodesis, complete wrist arthrodesis, scaphoidectomy, proximal row carpectomy (PRC), denervation, and radial styloidectomy <sup>2, 5, 6</sup>.</p>
Image 12 X-ray (Frontal) ( create )
Unable to process the form. Check for errors and try again.