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Scapholunate advanced collapse

Wrist osteoarthritis is a group of mechanical abnormalities resulting in joint destruction, which can occur in the wrist. These abnormalities include degeneration of cartilage and hypertrophic bone changes, which can lead to pain, swelling and loss of function. Osteoarthritis of the wrist is one of the most common conditions seen by hand surgeons.Stage IStage IIStage IIIStage IV Wrist osteoarthritis is a group of mechanical abnormalities resulting in joint destruction, which can occur in the wrist. These abnormalities include degeneration of cartilage and hypertrophic bone changes, which can lead to pain, swelling and loss of function. Osteoarthritis of the wrist is one of the most common conditions seen by hand surgeons. Osteoarthritis of the wrist can be idiopathic, but it is mostly seen as a post-traumatic condition. There are different types of post-traumatic osteoarthritis. Scapholunate advanced collapse (SLAC) is the most common form, followed by scaphoid non-union advanced collapse (SNAC). Other post-traumatic causes such as intra-articular fractures of the distal radius or ulna can also lead to wrist osteoarthritis, but are less common. SLAC and SNAC are two patterns of wrist osteoarthritis, following predictable patterns depending of the type of underlying injury. SLAC is caused by scapholunate ligament rupture, and SNAC is caused by a scaphoid fracture which does not heal and because of that will develop in a non-union fracture. SLAC is more common than SNAC; 55% of the patients with wrist osteoarthritis has a SLAC wrist. Scapholunate advanced collapse (SLAC) is a predictable pattern of wrist osteoarthritis that results from untreated long-standing scapholunate instability, which in turn is secondary to a rupture of the scapholunate ligament. The main type of such misalignment is dorsal intercalated segment instability (DISI) which is where the lunate angulates to the posterior side of the hand. SLAC is present in about 85% of untreated cases of scapholunate instability after 36 months. Scaphoid non-union fractures changes scaphoid bone shape, which leads to abnormal joint kinematics. Due to lack of stability from the distorted scaphoid, a DISI can be developed.Scaphoid Non-union Advanced collapse (SNAC) is the pattern of osteoarthritis that eventually develops by this process. Post-traumatic osteoarthritis can be classified into four stages. These stages are similar between SLAC and SNAC wrists. Each stage has a different treatment. The most common initial symptom of wrist osteoarthritis is joint pain. The pain is brought on by activity and increases when there is activity after resting. Other signs and symptoms, as with any joint affected by osteoarthritis, include: These symptoms can lead to loss of function and less daily activity.

[ "Arthritis", "Nonunion", "Osteoarthritis", "Arthrodesis", "four corner arthrodesis" ]
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