Scapholunate Advanced Collapse

Excerpt

Scapholunate advanced collapse (SLAC) describes a characteristic degenerative clinical wrist condition of progressive instability, deformity, and arthritis affecting the radiocarpal and midcarpal joints of the wrist. The characteristic pattern of arthritic deformity and progressive instability occurs secondary to a long-term, chronic dissociation between the lunate and the scaphoid carpal bones. SLAC of the wrist is often the terminal and end-stage result of an untreated scapholunate interosseous ligament (SLIL) injury. Radiographic, computerized tomography and magnetic resonance imaging often demonstrate widening of the scapholunate interval, degenerative changes of the affected carpal bones, and proximal migration of the capitate. A 4-stage categorization to grade arthrosis is often used.

Treatment most commonly includes 4-corner arthrodesis, capitolunate arthrodesis, radial styloidectomy, proximal row carpectomy, and scaphoidectomy. This condition was first described by Watson and Bellet when they reviewed 4000 wrist radiographs and discovered the common pattern of wrist bone involving arthritis in 210 wrists.