The Natural History of an Untreated Isolated Scapholunate Interosseous Ligament Injury

Author(s): O’Meeghan CJ, Stuart W, Mamo V, Stanley JK, Trail IA

Source: J Hand Surg 28B:307-10, 2003.

Summary:

The authors report 11 patients who have an arthroscopically proven scapholunate interosseous ligament injury.  There were no signs of DISI or scapholunate interval gapping on either standard or stress wrist radiographs.  At an average follow-up of 7 years (range 2.5 - 13 years), all patients reported persistent wrist pain of variable severity and functional limitations.  However, no patient had radiographic widening of the scapholunate interval or a DISI deformity.  Changes of degenerative arthritis, localizing to the radiocarpal joint, were detected in one individual.

Watson and Ballet (JHS 9A:358-65, 1984) described secondary arthritis in the wrist developing in the presence of an unstable, static scapholunate dissociation (SLAC wrist).  It is clear that S-L injuries represent a spectrum of soft-tissue disruption and there are clearly primary and secondary stabilizers of this joint.  This article describes a small population of individuals with arthroscopic tears without radiographic dissociation (stable scapholunate injuries.)  A larger patient population with a longer follow-up period would be valuable in further assessing the natural history of “stable” scapholunate interosseous ligament tears.

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J Hand Surg 28B:307-10, 2003.