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Scapholunate instability. : Diagnosis - classification - treatment.

J Willebrand1

  • 1Bereich Handchirurgie, Krankenhaus Waldfriede, Berlin, Germany.

Der Orthopade
|March 2, 2017
PubMed
Summary

Scapholunate instability, often from injury, involves ligament damage between the lunate and scaphoid bones. Treatment ranges from non-operative for Stage I to surgical interventions for advanced stages, including fusions.

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Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Anatomy
  • Musculoskeletal Injuries

Background:

  • Scapholunate instability results from injury to the ligament connecting the lunate and scaphoid bones.
  • Subtle widening of the scapholunate space can indicate instability, often missed in early diagnosis.
  • Diagnosis relies on physical examination, X-rays, and arthroscopy.

Purpose of the Study:

  • To outline the diagnostic methods for scapholunate instability.
  • To describe the three-stage classification of scapholunate instability.
  • To detail the treatment progression based on instability stage.

Main Methods:

  • Physical examination for assessing wrist joint stability.
  • Radiographic imaging (X-ray) to evaluate scapholunate joint space.
Keywords:
Key words Wrist • Instability • Suture of ligament •Ligamentoplasty • Arthrodesis

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  • Arthroscopic evaluation for direct visualization of ligament integrity.

    • Main Results:

    • Scapholunate instability is classified into three distinct stages.
    • Stage I instability is manageable with non-operative treatment.
    • Stages II and III require operative intervention, progressing from ligament repair to wrist fusion.

    Conclusions:

    • Early diagnosis of scapholunate instability is crucial for effective management.
    • Treatment strategies are stage-dependent, ranging from conservative care to extensive surgical reconstruction.
    • Advanced stages may necessitate wrist arthrodesis (fusion) for definitive stability.