Proposition of a new classification for scapholunate instability

• Authors: Ahmed Elsaftawy
• Languages of publication: EN

Abstracts

EN

Scapholunate (SL) instability is the most common pattern of instabilities in the wrist. If untreated or undiagnosed, it may lead to degenerative changes with SLAC (scapholunate advanced collapse) wrist. There are a few of of well-known SL instability classifications. The one that takes into account a dynamic or static nature of SL instability is the most accepted and used. The arthroscopic classifications are also becoming more and more popular. The aim of the study was the critical review of most popular classifications of SL instability, yet at the same time we proposed a new SL instability classification. Results. The new classification was found to be very useful in the process of diagnosis and decision making concerning further treatment of patients with SL instability in our department. Conclusions. The proposed new classification combines the opportunity of evaluating the scapholunate interosseus ligament (SLIL) tear and lesions of the secondary static stabilizers of SL ligament complex that can coexist with or without DISI deformity (Dorsal Intercalated Segmental Instability).

Keywords

EN

scapholunate instability; scapholunate ligament tear; scapholunate dissociation; rotatory subluxationa of scaphoid; new classification

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 11
• Pages: 676-680

Dates

published

1 - 11 - 2013

online

31 - 12 - 2013

Contributors

author

Ahmed Elsaftawy

• Department of General Surgery, Centre of Limbs Replantation, Microsurgery and Hand Surgery at St. Hedwig Hospital in Trzebnica

References

• 1. Linscheid RL, Dobyns JH , Beabout JW et al.: Traumatic instability of the wrist. Diagnosis, classification and pathomechanics. J Bone Joint Surg Am 1972; 54(8): 1612-32.[PubMed]
• 2. Talesinik J: The ligaments of the wrist. J Hand Surg Am 1976; 1(2): 110-18.[Crossref]
• 3. Mayfield JK , Johnson RP, Kilcoyne RK : Carpal dislocations: pathomechanics and progressive perilunate instability. J Hand Surg Am 1980; 5(3): 226-41.[PubMed][Crossref]
• 4. Berger RA , Blair WF, Crowninshield RD et al.: The scapholunate ligament. J Hand Surg Am 1982; 7(1): 87-91.[Crossref][PubMed]
• 5. Elsaftawy A: Prostowniki promieniowe nadgarstka jako dynamiczne stabilizatory kompleksu łódeczkowato- księżycowatego. Pol Przegl Chir 2013; 8(85): 816-28.
• 6. Żyluk A, Piotuch B: The management of scapholunate wrist instability: A review. Polish Orthopedics and Traumatology 2012; 77: 83-89.
• 7. Żyluk A, Jotuch B, Mazur A: Niestabilność łódeczkowo- księżycowata nadgarstka- przegląd piśmiennictwa. Chir Narządów Ruchu i O rtop Pol 2011; 76(3): 175-81.
• 8. Kuo CE , Wolfe SW : Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am 2008; 33(6): 998-1013.[Crossref][PubMed]
• 9. Willebrand J: Scapholunate instability. Diagnosis - classification - treatment. Orthopade 1999; 28(10): 878-82.[Crossref][PubMed]
• 10. Geissler WB: Arthroscopic management of scapholunate instability. Chir Main 2006; 25 Suppl 1: S187-96.[Crossref]
• 11. Garcia-Elias M, Lluch AL, Stanley JK : Threeligament tenodesis for the treatment of scapholunate dissociation: indications and surgical technique. J Hand Surg Am 2006; 31(1): 125-34.[Crossref]
• 12. Blatt G: Capsulodesis in reconstructive hand surgery. Dorsla capsulodesis for the unstable scaphoid and volar capsulodesis following excision of the distal ulna Hand Clin 1987; 3(1): 81-102.
• 13. Szabo RM, Slater RR , Palumbo CF, Gerlach T: Dorsal intercarpal ligament capsulodesis for chronic, static scapholunate dissociation: clinical results. J Hand Surg 2002; 27: 978-84.
• 14. Brunelli GA, Brunelli GR: A new technique to correct carpal instability with scaphoid rotary subluxation: a preliminary report. J Hand Surg Am 1995; 20(3 Pt 2): S82-85.[Crossref]
• 15. Van Den Abbeele KL, Loh YC , Stanley JK et al.: Early results of a modified Brunelli procedure for scapholunate instability. J Hand Surg Br 1998; 23(2): 258-61.
• 16. Harvey EJ , Berger RA , Osterman AL et al. Bone-tissue-bone repairs for scapholunate dissociation. J Hand Surg 2007; 32A: 256-64.[WoS]
• 17. Davis CA , Culp RW , Hume EL, Osterman AL: Reconstruction of the scapholunate ligament in a cadaver model using a bone-ligament-bone autograft from the foot. J Hand Surg Am 1998; 23(5): 884-92.[Crossref]
• 18. Cha SM, Shin HD , Kim KC : Clinical and Radiological Outcomes of Scaphoidectomy and 4-Corner Fusion in Scapholunate Advanced Collapse at 5 and 10 Years. Ann Plast Surg 2013; 12.[Crossref]
• 19. Shah CM, Stern PJ: Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist arthritis. Curr Rev Musculoskelet Med 2013; 6(1): 9-17.[PubMed][Crossref]
• 20. Danoff JR , Karl JW , Birman MV, Rosenwasser MP: The use of thermal shrinkage for 1scapholunate instability. Hand Clin 2011; 27(3): 309-17.[WoS][Crossref][PubMed]
• 21. Peicha G, Seibert FJ, Fellinger M et al. Lesions of the scapholunate ligaments in acute wrist trauma-- arthroscopic diagnosis and minimally invasive treatment. Knee Surg Sports Traumatol Arthrosc 1997; 5(3): 176-83.[Crossref][PubMed]

Identifiers

DOI

10.2478/pjs-2013-0103