Prognosis | Scapholunar dissociationSLD

Prognosis

The prognosis of a scapholunar dissociation cannot be given in general terms, but must be made dependent on the respective extent and concomitant injuries. It is important to notice the injury early. If the diagnosis is made immediately, the injury can heal stably and sustainably within 6 weeks with conservative therapy and consistent immobilization.

Operative sutures of the torn ligament are also possible within the first month. Afterwards, surgical therapies can only restore the anatomy with difficulty. In many cases, the joint must be stabilized by other means, in some cases even by partial stiffening. The most important goal is to achieve the best possible pain-free movement in the joint. This is usually possible after the therapy.

When does one need surgery?

Scapholunar dissociation can take on different dimensions and thus be associated with different complaints and consequences. The disease can be divided into 3 degrees. In all cases there is damage to the scapholunar ligament, which can cause the lunar and scaphoid bone to slip apart.

If there is only a slight displacement of the bones, a so-called “luxation”, a conservative therapy may be sufficient. From grade 2 on, however, further displacements, malpositions, instabilities, cartilage and bone damage occur in addition. In these cases, surgical treatments are necessary to treat the injured structures and to fix the SL ligament. Various surgical procedures are available for this purpose; in some cases, minimally invasive arthroscopy is also possible.