Abstract
Background:The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures. However, it remains unclear what patients develop symptoms, making primary treatment of these injuries accompanying distal radius fractures remains questionable.Objective:The aim of this study was to evaluate the functional outcomes of patients with scapholunate diastasis associated with distal radius fractures.Methods:We evaluated 391 patients with a distal radius fracture. Using Computer Tomography (CT) scans the scapholunate interval was measured. We identified 14 patients with an SLD (>3mm) of the injured wrist, which underwent a CT-scan of the contralateral wrist. To evaluate the functional outcomes at a mean follow up of 136±90 weeks, we used the Quick Disabilities of the Arm, Shoulder and Hand (qDASH) Score.Results:There were 8 patients with bilateral SLD and 6 patients with unilateral SLD. Five patients had a qDASH score of 0 and one patient showed a qDASH score of 18.2. The patient with a poor score had bilateral preexisting osteoarthritis of the wrist. No patient had additional surgery of the SLIL.Conclusion:In patients with distal radius fractures, more than half of the 14 patients with an SL gap on CT had widening on the contralateral side. It is therefore worthwhile to image the contralateral wrist before diagnosing a SLD. The patients with unilateral SLD should not be surgically treated at initial presentation because they may have good functional outcomes after a follow up of 2 years.
Highlights
Scapholunate Interosseous Ligament (SLIL) injury accompanies intra-articular radius fractures in 5-64% [1 - 8]
Background: The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures
In patients with distal radius fractures, more than half of the 14 patients with an SL gap on Computer Tomography (CT) had widening on the contralateral side
Summary
Scapholunate Interosseous Ligament (SLIL) injury accompanies intra-articular radius fractures in 5-64% [1 - 8]. Injury of the SLIL can lead to scapholunate dissociation (SLD) eventually leading to a scapholunate advanced collapse (SLAC) of the wrist in some cases [6, 10, 11]. It is important to perform scapholunate ligament reconstruction before this cascade begins It is unpredictable what patients will develop symptoms [15]. The Scapholunate Interosseous Ligament (SLIL) is the first intrinsic carpal ligament to be injured in wrist trauma, present in up to 64% of the distal radius fractures. It remains unclear what patients develop symptoms, making primary treatment of these injuries accompanying distal radius fractures remains questionable
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