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[Treatment options for scaphoid nonunion advanced collapse].
1Unfall‑, Hand und Wiederherstellungschirurgie, Helios Klinikum Meiningen, Akademisches Lehrkrankenhaus des Universitätsklinikums Jena, Bergstr. 3, 98617, Meiningen, Deutschland. reinhard.meier@handchirurg.org.
Der Unfallchirurg
|March 20, 2019
Summary
Untreated scaphoid nonunion often leads to SNAC wrist. Treatment options range from reconstruction for early stages to salvage procedures like wrist fusion or replacement for advanced stages to manage pain and preserve function.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Traumatology
Background:
- Untreated scaphoid nonunion frequently progresses to scaphoid nonunion advanced collapse (SNAC) wrist.
- SNAC wrist represents a spectrum of wrist degeneration following scaphoid bone injuries.
Purpose of the Study:
- To outline the treatment strategies for scaphoid nonunion advanced collapse (SNAC) wrist.
- To differentiate between reconstructive and salvage procedures based on SNAC wrist severity.
Main Methods:
- Review of treatment modalities for SNAC wrist.
- Categorization of procedures based on disease stage (e.g., Stage I vs. higher degrees).
Main Results:
- Reconstructive surgery combined with radial styloid resection shows promise for Stage I SNAC wrist.
- Salvage procedures including denervation, proximal row carpectomy, and partial wrist fusion can reduce pain and maintain wrist mobility in higher stages.
- Total wrist arthrodesis and total wrist arthroplasty are options for advanced panarthritis or failed motion-preserving surgeries.
Conclusions:
- Treatment for SNAC wrist should be tailored to the stage of the condition.
- Both motion-preserving and motion-sacrificing procedures have roles in managing SNAC wrist, aiming to alleviate pain and functional deficits.
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