Frequency of Scapholunate Ligament Injuries Associated with Distal Radius Shearing Fracture: Correlation of Fracture Patterns and Ligament Tear.

Abstract

BACKGROUND:

This retrospective study assessed the prevalence and outcome of intercarpal ligament injuries in non-osteoporotic patients with AO/ASIF classification type B distal radius shearing fractures treated with or without scapholunate temporary fixation.

METHODS:

Fifteen patients (mean age, 33 years) were analyzed according to their scapholunate ligament status at the time of injury and graded with a modified Geissler classification system. Each patient's postoperative pain and occupational status were assessed in the context of the Modified Mayo wrist score. Second-look arthroscopy was performed for all cases.

RESULTS:

Scapholunate ligament injuries were present in 14 of 15 type B fractures. Surgical outcomes yielded an improvement in the Mayo wrist score with pinning in cases involving grade 3 or 4 scapholunate injuries. Two cases without pinning had a worse score, as well as a persistent scapholunate tear that was not healed at second-look arthroscopy after eight postoperative months. However, in grade 1 or 2 scapholunate injuries, the Mayo wrist score did not differ between those treated with and without pinning.

CONCLUSIONS:

Scapholunate ligament injury is an important risk factor associated with high-energy distal radius shearing fractures. To prevent these problems, temporary scapholunate joint fixation is a recommended treatment for grade 3 or 4 scapholunate injuries.

• Authors: Shiro Yoshida, Kenji Yoshida, Kensuke Sakai, Kenjiro Nakama, Naoto Shiba
• Journal: Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand (Hand Surg) Vol. 20 Issue 3 Pg. 440-6 (Oct 2015) ISSN: 1793-6535 [Electronic] Singapore
• PMID: 26388007 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Arthroscopy
• Bone Nails
• Female
• Fracture Fixation, Intramedullary (methods)
• Humans
• Japan (epidemiology)
• Ligaments, Articular (injuries, surgery)
• Male
• Middle Aged
• Prevalence
• Radius Fractures (complications, surgery)
• Retrospective Studies
• Rupture
• Wrist Injuries (epidemiology, etiology, surgery)
• Young Adult