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Chronic asymptomatic contralateral wrist scapholunate dissociation
Idriss S Gharbaoui1, David T Netscher, Fred B Kessler
1Division of Plastic Surgery, Baylor College of Medicine, Veterans Affairs Medical Center, Houston, Texas, USA.
Plastic and Reconstructive Surgery
|November 4, 2005
Summary
Bilateral scapholunate dissociation often presents benignly, but dorsal intercalated segment instability can rapidly lead to degenerative wrist arthritis. Early detection and monitoring are crucial for managing this condition.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Radiology
Background:
- Reports on bilateral scapholunate dissociation without prior trauma or systemic conditions are rare.
- This study presents a series of six patients with this uncommon wrist condition.
Observation:
- Patients presented with unilateral wrist pain or snapping, with bilateral scapholunate gapping discovered on radiographs.
- Follow-up averaged 39 months, with radiographic and questionnaire data collected.
Findings:
- Ten wrists showed radiographic signs of scapholunate dissociation (widened angles, scaphoid subluxation) but had mild or no pain.
- One patient with severe unilateral instability underwent surgical repair; another with moderate instability declined surgery.
Implications:
- Bilateral scapholunate dissociation appears to have a benign natural history unless dorsal intercalated segment instability develops.
- The presence of dorsal intercalated segment instability may accelerate progression to degenerative arthritis and wrist collapse.