Introduction. Scapholunate advanced collapse (SLAC) describes a characteristic degenerative clinical wrist condition of progressive instability, deformity, and arthritis affecting the radiocarpal and midcarpal joints of the wrist. [

How do you treat a SLAC wrist?

Asymptomatic (SLAC) wrist generally does not require treatment. Symptomatic mild SLAC is managed nonoperatively, for example, wrist immobilization with splints, nonsteroidal anti-inflammatory drugs, and corticosteroid injections.

What causes SLAC?

CAUSES. Most cases of SLAC wrist start with a significant wrist sprain or fracture, but occasionally no history of injury is recalled. Some cases of scapholunate ligament injury may be due to repetitive heavy loading of the wrist as seen with obesity, or inflammatory conditions of the wrist that damage the ligament.

What are the symptoms of SLAC wrist?

• Difficulty with weight-bearing across the wrist.
• Significant pain in the area of the scapholunate interval.
• Progressive weakness of the involved hand.
• Wrist stiffness.
• Weak grip strength.
• Tenderness to palpation.
• Reduced range of motion of the wrist.

What does SLAC wrist mean?

Scapholunate advanced collapse (SLAC) of the wrist is the most common pattern of degenerative arthritis in the wrist. The hallmark of SLAC is scaphoid or scapholunate ligament injury with collapse on the radial side of the wrist. Watson and Ballet coined the term SLAC wrist in 1984.

What is Stage 3 SLAC wrist?

Stage III SLAC wrist entails sclerosis and joint space narrowing between the lunate and capitate. Eventually, the capitate will migrate proximally into the space created by the scapholunate dissociation.

How common is SLAC wrist?

There are three different patterns of arthropathy seen about the wrist which include SLAC, triscaphe arthritis (between the trapezium, trapezoid and distal scaphoid) and a combination pattern. SLAC wrist is the most common type of wrist arthritis and accounts for approximately 55 % of all wrist arthritis [14].

Where is the capitate bone?

The capitate is a carpal bone located in the most central portion of the wrist. The bones of the wrist are called carpals and the bones of the hand are called metacarpals. The capitate is the largest of the carpal bones. It lies between the trapezoid and hamate, which are also carpal bones.

What is scapholunate?

The scapholunate is an interosseous carpal ligament that provides stability to the proximal carpal row. It consists of dorsal, proximal and palmar segments that bridge the scaphoid and lunate.

What is widening of the scapholunate interval?

The scapholunate interval or gap is the radiographic measurement of the scapholunate joint and widening is indicative of a scapholunate ligament injury.

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What causes scapholunate widening?

Scapholunate dissociation most commonly results from trauma. It is the leading cause of SLAC (scapholunate advanced collapse) wrist, which is the most common pattern of degenerative arthritis in the wrist 4.

What bones are in wrist?

Your wrist is made up of eight small bones (carpal bones) plus two long bones in your forearm — the radius and the ulna. Each finger consists of one hand bone (metacarpal) and three finger bones (phalanges), while each thumb consists of one metacarpal bone and two phalanges.

How do you treat a scapholunate ligament tear?

Treatment for a Scapholunate ligament tear This may involve a wrist brace or a cast for 2-6 weeks, minimizing activity that causes pain such a tight gripping or pushing, and anti-inflammatory medications such as ibuprofen.

Is there such a thing as a wrist replacement?

Although performed less commonly than hip or knee replacement, wrist replacement can provide relief from pain and instability while preserving the range of motion needed for daily activities. “Wrist replacement can be an option for patients who are reluctant to have a wrist fusion.

Why does my wrist hurt a year after breaking it?

The third common form of wrist arthritis is called Post Traumatic Arthritis. Generally, this type of arthritis may develop in the months to years following a fracture or other severe injury in the wrist.

How long does it take for a scapholunate ligament tear to heal?

These injuries are usually considered as ligament sprains where one or 2 parts of this 3 part ligament is injured, but there is no instability in the wrist. They respond well to a period of immobilization in plaster (4-6 weeks) followed by analgesia and hand therapy. Recovery can take up to 18 months.

How do you dislocate lunate?

Perilunate and lunate dislocations result when great force is applied to a hyperextended wrist. They usually result from a fall on an outstretched hand or occur in a motor vehicle crash.

What is PRC surgery?

Brief Summary: In cases of severe arthritis of the wrist, surgical removal of the scaphoid, lunate and triquetrum bones or proximal row carpectomy (PRC) is a well-known procedure. This procedure converts the wrist in a simple hinged joint but allows us to preserve a certain range of motion in the wrist.

Where is the radial styloid?

The radial styloid process is found on the lateral surface of the distal radius bone. It extends obliquely downward into a strong, conical projection.

Why is arthrodesis performed?

Arthrodesis, also known as artificial ankylosis or syndesis, is the artificial induction of joint ossification between two bones by surgery. This is done to relieve intractable pain in a joint which cannot be managed by pain medication, splints, or other normally indicated treatments.

What is the ICD 10 code for SLAC wrist?

Primary osteoarthritis, unspecified wrist M19. 039 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

Is scaphoid hand or wrist?

The scaphoid bone is one of the carpal bones on the thumb side of the wrist, just above the radius. The bone is important for both motion and stability in the wrist joint. The word “scaphoid” comes from the Greek term for “boat.” The scaphoid bone resembles a boat with its relatively long, curved shape.

How long does Scapholunate surgery take?

Healing of the Scapholunate Ligament takes approximately 3 months. This procedure is usually performed under general anesthesia which means you will be asleep for the procedure. Your procedure will take approximately 3 hours– including recovery time.

Where is the Scapholunate located?

When a ligament is injured, this is referred to as a sprain. A very common ligament injured in a sprained wrist is the scapholunate ligament. This ligament is in the middle of the wrist between the scaphoid and lunate bones (Figure 1). It is an important structure for painless and full wrist motion.

What is a positive Watson test?

A truly positive test requires both pain on the back of the wrist (not just where you are pressing on the scaphoid tuberosity), and comparison with the opposite wrist is essential.”

What is the biggest wrist bone?

The capitate bone is the largest of all the carpal bones, both proximally and distally. It is surrounded by the lunate bone proximally, the third metacarpal bone distally, the trapezoid bone laterally and the hamate bone medially.

What does the capitate do?

Function. The carpal bones function as a unit to provide a bony superstructure for the hand. They allow movements of the wrist from side to side (medial to lateral) as well as up and down (anterior to posterior).

Can you break your capitate bone?

FRACTURES OF THE CAPITATE. Fractures of the capitate are rare and account for only 1.3% of all carpal fractures. Most of these fractures occur in association with additional carpal pathology, particularly scaphoid fractures; isolated fractures of the capitate make up only 0.3% of carpal injuries.

What is normal scapholunate?

For normal wrists, the mean scapholunate measurements were all less than 2.0 mm at the middle of the joint, regardless of imaging modality or wrist position. Fluoroscopy detected significance between more stages of instability than plain radiographs at the middle of the joint.

What is Type 2 lunate?

According to this description, a type I lunate has a single distal facet for the capitate, and does not articulate with the hamate. In contrast, a type II lunate has two distal facets; the radial facet articulates with the capitate and the ulnar facet with the hamate.

What is a scapholunate dislocation?

Scapholunate dissociation is a rotatory subluxation of the scaphoid with widening of the gap between the scaphoid and lunate. It is caused by rupture of the ligaments between radius, scaphoid, lunate and capitate bones.