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

Hand Surgery 2015 October
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.

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