Ante Mrkonjic1, Tommy Lindau2, Mats Geijer3, Magnus Tägil4. 1. Department of Hand Surgery, Clinical Sciences, Lund University and Skåne University Hospital, Sweden. Electronic address: anteort@gmail.com. 2. Pulvertaft Hand Centre, Derby, United Kingdom. 3. Center of Medical Imaging and Physiology, Clinical Sciences, Lund University and Skåne University Hospital, Sweden. 4. Department of Orthopedics, Clinical Sciences, Lund University and Skåne University Hospital, Sweden.
Abstract
PURPOSE: To evaluate the natural history of untreated complete or partial scapholunate (SL) ligament tears associated with displaced distal radius fractures. METHODS: Between 1995 and 1997, 51 consecutive patients aged < 60 years with displaced distal radius fractures were examined arthroscopically to assess for concomitant soft tissue injuries. Thirty-two of 51 patients had an SL ligament tear, 10 had a complete tear (Lindau grade 3), and 22 had a partial tear (Lindau grades 1 and 2). Thirty-two patients had AO type-C fractures, 3 had type-B fractures, and 16 had type-A fractures. In 2010, 47 of the 51 patients were still alive, and they were invited for an interview, clinical examination, and radiography. RESULTS: Thirty-eight of the 51 original patients participated in the long-term follow-up. Mean grip strength was 83% relative to the contralateral hand in patients with a complete tear, as compared with 92% in patients with partial or no SL tears (nonsignificant). Median Disabilities of the Arm, Shoulder, and Hand questionnaire score was 2 (range, 0‒55) for complete SL tears, compared with 9 (range, 0‒70) for the others (nonsignificant). No differences were found regarding visual analog scale pain or wrist motion/forearm rotation. None of the patients developed a static SL dissociation or a SL advanced collapse wrist. CONCLUSIONS: No major differences were found in the subjective, objective, or radiographic outcome after a complete (grade 3) or partial (grade 1 or 2) SL untreated tear associated with displaced distal radius fracture. It should be noted that none of the patients had a grade 4 SL tear, which may have a different outcome. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
PURPOSE: To evaluate the natural history of untreated complete or partial scapholunate (SL) ligament tears associated with displaced distal radius fractures. METHODS: Between 1995 and 1997, 51 consecutive patients aged < 60 years with displaced distal radius fractures were examined arthroscopically to assess for concomitant soft tissue injuries. Thirty-two of 51 patients had an SL ligament tear, 10 had a complete tear (Lindau grade 3), and 22 had a partial tear (Lindau grades 1 and 2). Thirty-two patients had AO type-C fractures, 3 had type-B fractures, and 16 had type-A fractures. In 2010, 47 of the 51 patients were still alive, and they were invited for an interview, clinical examination, and radiography. RESULTS: Thirty-eight of the 51 original patients participated in the long-term follow-up. Mean grip strength was 83% relative to the contralateral hand in patients with a complete tear, as compared with 92% in patients with partial or no SL tears (nonsignificant). Median Disabilities of the Arm, Shoulder, and Hand questionnaire score was 2 (range, 0‒55) for complete SL tears, compared with 9 (range, 0‒70) for the others (nonsignificant). No differences were found regarding visual analog scale pain or wrist motion/forearm rotation. None of the patients developed a static SL dissociation or a SL advanced collapse wrist. CONCLUSIONS: No major differences were found in the subjective, objective, or radiographic outcome after a complete (grade 3) or partial (grade 1 or 2) SL untreated tear associated with displaced distal radius fracture. It should be noted that none of the patients had a grade 4 SL tear, which may have a different outcome. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
Authors: Spencer J. Montgomery; Natalie J. Rollick; Jeremy F. Kubik; Alexander R. Meldrum; Neil J. White Journal: Can J Surg Date: 2019-03-22 Impact factor: 2.089
Authors: William L Wang; Jack Abboudi; Gregory Gallant; Christopher Jones; William Kirkpatrick; Moody Kwok; Frederic Liss; T Robert Takei; Mark Wang; Asif M Ilyas Journal: Hand (N Y) Date: 2020-05-28