Proposition of a new classification for scapholunate instability

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Anatomy
• Biomechanics

Background:

• Scapholunate (SL) instability is the most prevalent wrist instability.
• Untreated SL instability can progress to Scapholunate Advanced Collapse (SLAC) wrist.
• Existing classifications for SL instability vary in acceptance and focus.

Purpose of the Study:

• To critically review current Scapholunate (SL) instability classifications.
• To propose a new, comprehensive classification for SL instability.
• To evaluate the utility of proposed classification in clinical practice.

Main Methods:

• Literature review of established SL instability classifications.
• Development of a novel classification system for SL instability.
• Retrospective analysis of patient data to validate the new classification.

Main Results:

• The new classification proved highly effective for diagnosis and treatment planning in clinical practice.
• The classification system integrates assessment of the scapholunate interosseous ligament (SLIL) and secondary stabilizers.
• It accounts for the presence or absence of Dorsal Intercalated Segmental Instability (DISI) deformity.

Conclusions:

• The proposed classification offers a valuable tool for managing Scapholunate (SL) instability.
• It facilitates a thorough evaluation of ligamentous structures and associated deformities.
• This new system enhances clinical decision-making for patients with wrist instability.