Comprehensive update on Advanced Scapholunate Collapse and Advanced Non-Union Scaphoid Collapse: A Scope Review.
DOI:
https://doi.org/10.26871/ceus.v8i1.296Keywords:
Osteoarthritis, scaphoid pseudoarthrosis, wrist, SNAC, SLAC, carpal instabilityAbstract
The wrist is a complete joint, making it essential to understand the pathologies it may have. Wrist osteoarthritis occurs as a periscaphoid problem in 95% of cases, with the most common patterns being advanced collapse without scaphoid union (SNAC) and advanced scapholunate collapse (SLAC).
SNAC results from a lack of union of a scaphoid fracture, leading to osteoarthritis. Pseudoarthrosis of the scaphoid results in distorted carpal kinematics, causing the distal row of the carpal bones to pronate and displace dorsally and ulnarly, which contributes to increased bone density in the capitolunate, radiolunate, and radial styloid joints, indicating degenerative changes. This damage is distributed across the scaphoid-trapezium-trapezoid joints, radial styloid-scaphoid joints, and scaphoid-capitate joints.
SLAC injury arises from chronic injury to the scapholunate ligament, resulting in scapholunate dissociation and carpal instability, which progresses to degenerative changes affecting the capitolunate, radiocarpal, and lunate-pyramidal joints.
Various treatments are generally surgical, such as four-corner arthrodesis and proximal row carpectomy, aimed at reducing pain and preventing disease progression.
Keywords: osteoarthritis, scaphoid pseudoarthrosis, wrist, SNAC, SLAC, carpal instability.
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