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Related Experiment Videos

Degenerative change in symptomatic scaphoid nonunion.

M I Vender, H K Watson, B D Wiener

    The Journal of Hand Surgery
    |July 1, 1987
    PubMed
    Summary

    Symptomatic scaphoid nonunions frequently lead to predictable arthritis, particularly scapholunate advanced collapse (SLAC) wrist. Early instability correlates with earlier arthritis onset in these wrist injuries.

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    Area of Science:

    • Orthopedic Surgery
    • Radiology
    • Hand and Wrist Anatomy

    Background:

    • Scaphoid nonunions are common wrist injuries.
    • Untreated symptomatic scaphoid nonunions can lead to degenerative changes.
    • The natural history and progression of arthritis in these cases require further elucidation.

    Purpose of the Study:

    • To analyze the radiographic progression of degenerative changes in symptomatic scaphoid nonunions.
    • To identify patterns and sequences of arthritis development.
    • To correlate instability with arthritis onset.

    Main Methods:

    • Retrospective radiographic analysis.
    • Inclusion of 64 patients with symptomatic scaphoid nonunions without prior surgery.
    • Assessment of degenerative changes over time and joint involvement.

    Main Results:

    • A high frequency of degenerative changes was observed in a predictable sequence.
    • Radioscaphoid changes occurred in 75% of nonunions after 4 years, and midcarpal changes in 60% after 9 years.
    • Scapholunate advanced collapse (SLAC) wrist pattern was identified, resulting from distal scaphoid fragment subluxation, while radiocarpal and radiolunate joints remained largely unaffected.

    Conclusions:

    • Symptomatic scaphoid nonunions have a significant likelihood of developing arthritis.
    • Arthritis progression is linked to instability, with earlier onset associated with increased instability.
    • The study highlights the predictable pattern of arthritis in untreated scaphoid nonunions, emphasizing the SLAC wrist progression.

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