Advertisement

Scapholunate dissociation associated with distal radius fractures

  • Izge Gunal
  • Dinc Ozaksoy
  • Taskin Altay
  • Ismail Safa Satoglu
  • Cemal KazimogluEmail author
  • Muhittin Sener
Original Article

Abstract

Objective

The exact prevalence of scapholunate dissociation (SLD) associated with distal radius fracture (DRF) and the effect of persistent SLD on the function of the wrist are not known. So, we examined the association between SLD and DRF and the effects of treatment on clinical outcomes.

Methods

Eight hundred and twenty-nine patients with 839 DRF were included in the study. The radiographs of the patients were examined with special reference to SLD both in pre- and post-reduction period. Persistent SLD cases were evaluated by the scoring system of Green and O’Brien at least 2 years after the fracture.

Results

Of the 839 fractures, 215 had SLD after the injury. When post-reduction radiographs were examined, SLD persisted in 98, but in 14 SLD was detected in the post-reduction period while not apparent in initial radiographs. So, a total of 112 patients (13.4 %) had persistent SLD. Nineteen patients were lost to follow-up and remaining 93 wrists examined clinically. Seventy-nine had pain on the scapholunate joint and 14 had not. When these patients were evaluated by Green and O’Brien system, symptomatic patients had fair or poor results but asymptomatic had good. The association between DRF and SLD is 13.4 %.

Conclusions

Severity of the distal radius fractures is not associated with SLD. Intra-articular fractures were associated with significant increase in the prevalence of SLD. In some cases, SLD may appear after reduction in distal radius. Most cases with SLD are symptomatic, and this may be the reason of poor cases following distal radius fracture.

Keywords

Distal radius Fracture Scapholunate dissociation 

Notes

Conflict of interest

The authors declare that there is no conflict of interest regarding this article.

References

  1. 1.
    Geissler WB, Freeland AE, Savoie FH, McIntyre LW, Whipple TL (1996) Intercarpal soft-tissue lesions associated with an intra-articular fracture of the distal end of the radius. J Bone Joint Surg [Am] 78:357–365Google Scholar
  2. 2.
    Kwon BC, Baek GH (2008) Fluoroscopic diagnosis of scapholunate interosseous ligament injuries in the distal radius fracture. Clin Orthop Rel Res 466:969–976CrossRefGoogle Scholar
  3. 3.
    Laulan J, Bismuth JP (1999) Intracarpal ligamentous lesions associated with fractures of the distal radius: outcome at one year. A retrospective study of 95 cases. Acta Orthop Belg 65:418–423PubMedGoogle Scholar
  4. 4.
    Lindau T, Arner M (1997) Intraarticular lesions in distal fractures of the radius in young adults. A descriptive arthroscopic study in 50 patients. J Hand Surg [Br] 22:638–643CrossRefGoogle Scholar
  5. 5.
    Peicha G, Seibert F-J, Fellinger M, Grechenig W (1999) Midterm results of arthroscopic treatment of scapholunate ligament lesions associated with intra-articular distal radius fracture. Knee Surg Sports Traumatol Arthrosc 7:327–333PubMedCrossRefGoogle Scholar
  6. 6.
    Richards RS, Bennett JD, Roth JH, Milne K Jr (1997) Arthroscopic diagnosis of intra-articular soft tissue injuries associated with distal radial fractures. J Hand Surg [Am] 22:772–776CrossRefGoogle Scholar
  7. 7.
    Tang J-B, Shi D, Gu YQ, Zhang QG (1996) Can cast immobilization treat scapholunate dissociation associated with distal radius fractures? J Hand Surg [Am] 2:583–590CrossRefGoogle Scholar
  8. 8.
    Forward DP, Lindau TR, Melsom DS (2007) Intercarpal ligament injuries associated with fractures of the distal part of the radius. J Bone Joint Surg [Am] 89:2334–2340CrossRefGoogle Scholar
  9. 9.
    Bloom HT, Freeland AE, Bowen V, Mrkonjic L (2003) The treatment of chronic scapholunate dissociation: an evidence–based assessment of the literature. Orthopedics 26:195–203PubMedGoogle Scholar
  10. 10.
    Green DP, O’Brien ET (1980) Classification and management of carpal dislocations. Clin Orthop Rel Res 149:55–72Google Scholar
  11. 11.
    Orthopaedic Trauma Association Classification, Database and Outcomes Committee (2007) Fracture and dislocation classification compendium. J Orthop Trauma 21(Suppl 10):19–30Google Scholar
  12. 12.
    Ozcelik A, Gunal I, Kose N (2005) Stress views in the radiography of scapholunate instability. Eur J Radiol 56:358–361PubMedCrossRefGoogle Scholar
  13. 13.
    Ozcelik A, Gunal I, Kose N, Seber S, Omeroglu H (2005) Wrist ligaments: their significance in carpal instability. Turk J Trauma Emerg Surg 11:115–120Google Scholar
  14. 14.
    Seber S, Gokdemir H, Ozcelik A, Gunal I, Aydin R, Kose N (2008) A two-dimensional wrist model for carpal instability and force transmission. Eklem Hastalik Cerrahis 19:127–132Google Scholar

Copyright information

© Springer-Verlag France 2012

Authors and Affiliations

  • Izge Gunal
    • 1
  • Dinc Ozaksoy
    • 2
  • Taskin Altay
    • 3
  • Ismail Safa Satoglu
    • 4
  • Cemal Kazimoglu
    • 4
    Email author
  • Muhittin Sener
    • 4
  1. 1.Department of OrthopedicsDokuz Eylul University HospitalBalcovaTurkey
  2. 2.Department of RadiologyDokuz Eylul University, Faculty of MedicineBalcovaTurkey
  3. 3.Department of OrthopedicsIzmir Training and Research HospitalBozyakaTurkey
  4. 4.Department of OrthopedicsIzmir Katip Celebi University, Faculty of MedicineIzmirTurkey

Personalised recommendations