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Asymptomatic SLAC wrist: does it exist?

P R Fassler1, P J Stern, T R Kiefhaber

  • 1Department of Orthopedic Surgery, University of Cincinnati, Ohio 45206.

The Journal of Hand Surgery
|July 1, 1993
PubMed
Summary
This summary is machine-generated.

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Scapholunate advanced collapse (SLAC) arthritis on X-ray may not correlate with wrist pain in some patients. Many patients with SLAC arthritis experience symptom resolution without surgery, suggesting non-operative management is often appropriate.

Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Radiology

Background:

  • Scapholunate advanced collapse (SLAC) is a common radiographic finding in wrist arthritis.
  • Clinical correlation between radiographic severity and patient symptoms can be variable.

Purpose of the Study:

  • To evaluate the natural history of symptomatic and asymptomatic scapholunate advanced collapse (SLAC) wrist.
  • To determine if radiographic evidence of SLAC arthritis correlates with clinical symptoms and warrants surgical intervention.

Main Methods:

  • Retrospective review of 30 wrists in 25 patients with radiographic evidence of SLAC wrist.
  • Assessment of pain, symptoms, and need for analgesics at initial diagnosis and an average of 2-year follow-up.
  • Evaluation of prior diagnoses and treatments, including carpal tunnel syndrome.

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Main Results:

  • At presentation, 22 wrists were asymptomatic, and 8 had mild pain.
  • After an average 2-year follow-up, 20 wrists were symptom-free, and 10 had occasional pain with activity (no analgesics required).
  • No patients underwent surgery for SLAC arthritis during the follow-up period.

Conclusions:

  • Radiographic findings of SLAC arthritis do not always correlate with clinical symptoms.
  • Many patients, particularly older, low-demand individuals, can be managed non-operatively with good outcomes.
  • Surgical intervention for SLAC arthritis may not be warranted in all cases, especially when clinical findings are minimal.