Radius and sl dis
Alle deler > BILL > Studier > Hånd abs
Finsen V, Rajabi B, Rød Ø, Rød K, Alm-Paulsen P S, Russwurm H,
THE CLINICAL OUTCOME AFTER EXTRA-ARTICULAR COLLES’ FRACTURES WITH SIMULTANEOUS MODERATE SCAPHOLUNATE DISSOCIATION
J Wrist Surg 2014; 3: 123-7.
Background: An increased scapholunate gap is sometimes seen in patients with a distal radial fracture. The question remains as to whether this represents a scapholunate ligament injury that requires treatment.
Questions/purposes: We wished to examine the natural history of an increased scapholunate gap in patients following an extra-articular distal radius fracture.
Patients and Methods: We reviewed 260 patients who had sustained a distal radius fracture 6.2 (2.7-11.9) years previously and identified 12 extra-articular fractures with an increased gap between the lunate and scaphoid. The mean scapholunate gap was 2.6 (2.1-3.4) mm and the mean scapholunate angle 62° (39°-90°). Controls were found among the remaining patients with extra-articular fractures.Selection criteria were: Same sex, age at fracture within 5 years, time between injury and review within 2 years, ulnar variance within 2 mm, and dorsal angulation within 5° of index patient. When more than one control fulfilled the criteria for an index patient, their values were averaged. In total there were 54 controls for the 12 index patients.
Results: The mean difference between index patients and controls in wrist range of motion was 4%, in grip strength 5%, in VAS for pain 1 (on a scale from 1 to 100), in Quick-DASH score 5, and in PRWE score 1. The study was calculated to have the power to detect a difference in Quick-DASH scores and in PRWE scores of 14.
Conclusions: We conclude that at a mean follow up of 6.2 years following an extra-articular distal radius fracture, no surgical treatment is usually needed with a scapholunate gap of between 2.1 – 3.4 mm is seen in patients with extra-articular distal radial fractures.