Surgical treatment of scapholunate advanced collapse

Joel D. Krakauer, Allen T. Bishop, William P. Cooney

Research output: Contribution to journalArticlepeer-review

245 Scopus citations


This study reports the outcomes of six different reconstructive procedures for stage II and stage III scapholunate advanced collapse (SLAC) wrist in 55 cases followed an average of 50 months. Scaphoid excision and intercarpal arthrodesis was performed in 31 cases: four-corner arthrodesis in 23 cases and capitolunate arthrodesis in 8 cases. Proximal row carpectomy was performed in 12 cases, radioscapholunate arthrodesis in 5 cases, radioscaphoid arthrodesis in 3 cases, and primary total wrist arthrodesis in 4 cases. Following surgical treatment the majority of patients in all groups had less wrist pain. The nonunion rate was four cases for the capitolunate arthrodesis group compared with two for the four-corner arthrodesis group. Six of 51 motion-sparing cases were converted to total arthrodeses. Scaphoid excision and four-corner arthrodesis reliably diminished wrist pain in patients with state III SLAC wrist while maintaining a 54° flexion-extension arc. Stage II SLAC wrist can be successfully treated with this procedure, radioscaphoid arthrodesis, or proximal row carpectomy. Of the three procedures, proximal row carpectomy best preserves wrist mobility, with a flexion-extension arc of 71°.

Original languageEnglish (US)
Pages (from-to)751-759
Number of pages9
JournalJournal of Hand Surgery
Issue number5
StatePublished - Sep 1994

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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