Synonyms in a broader sense
- Scapholunary dissociation
- Scaphoid luxation
- Ligament injury of the wrist
- Distal radius fracture
- Hand Injury
There are these possibilities of therapy
In principle, scapholunar dissociation can be treated both conservatively and surgically. The conservative therapy is a treatment method for slight displacements of the scaphoid and lunar bone, if there are no other accompanying injuries. In addition to immobilization and protection, it also includes pain therapy adapted to the patient.
After a certain period of time, a light movement therapy is necessary to restore and maintain mobility and to strengthen the ligamentous apparatus of the wrist in order to prevent bone displacement. Surgical procedures available include arthroscopy, direct suturing of the scapholunar ligament, ligament reconstruction and transplantation, as well as partial and complete stiffening of the affected joints. The choice of the treatment method is based on the severity of the injury, the prospect of recovery, the age of the patient, and the patient’s wishes.
The conservative therapy is used in cases of slight dissociation of the two carpal bones. In this case, a reduction must be performed early after the injury. In this process, the bones are pushed back into their original positions from the outside while pain is being relieved.
Further conservative therapy consists of a consistent immobilization of the wrist. Hand bandages or plaster casts can be used for this purpose. Immobilization should be carried out for 4-6 weeks.
Afterwards, the wrist should be continued with care. Tape bandages can be applied for this purpose. At the beginning of the treatment, the hand should be compressed, cooled and raised to prevent bruising and swelling. Throughout the entire treatment period, painkillers can be taken as needed to alleviate the symptoms.
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Depending on the severity of the injury, several surgical procedures are available. With the help of so-called “keyhole surgery”, many treatments of a minor scapholunar dissociation can already be performed. Parts of the ligaments can be removed, pieces of cartilage and bone can be removed from the joint space and the bones can be examined in detail in their anatomical position.
For sutures and further operations, however, an incision must be made above the joint. Within 6 weeks after the injury, it is possible to suture the scapholunar ligament directly. Afterwards, this is often no longer possible, so that surgical ligament reconstruction or transplantation of a ligament can be considered.
However, these procedures often have little chance of success. The last option for surgical therapy is partial stiffening at the carpus. This is still feasible even in cases of cartilage damage and joint arthrosis and provides a good and painless result in the long term. Only the mobility of the wrist is limited by this treatment.
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