When does one need surgery? | Therapy of scapholunary dissociationSLD

When does one need surgery?

In scapholunar dissociation there are many different manifestations of the disease. A fall or a violent impact damages the ligaments of the carpal bones, allowing them to emerge from their rigid skeleton. If the small carpal bones leave their anatomical place, one speaks of a dislocation.

If, however, in addition to torn ligaments, damage to the articular cartilage, considerable displacement of the scaphoid or lunate bone or even bony damage occurs, surgical procedures must be considered. The primary goal is to preserve the anatomical joint surfaces and positions of the bones and to heal possible instabilities or concomitant injuries. If the rupture of ligaments causes bone displacement, simple reduction and immobilization is often not sufficient. Especially when the scaphoid is broken in connection with the injury, surgical therapy is necessary to prevent arthrosis and wear and tear in the wrist in the long term.

Aftercare

In the case of conservative immobilization or after surgical therapies, a treatment of 6 weeks is often necessary. During this time, ligament structures can grow together stably and injuries can heal.The joint should be splinted in a plaster or bandage and immobilized. Even after the 6 weeks, it is still indicated to take it easy. The wrist should be slowly mobilized through active and passive movement exercises to restore mobility. The aim of all therapies is to achieve the best possible long-term and pain-free movement of the wrist.

Duration

The duration of treatment is often given as 6 weeks for both conservative and surgical therapies. However, even beyond this period, the wrist must be further protected and slowly mobilized. A further treatment period of 6 weeks achieves a good and stable mobility of the joint.

The duration of the complaints can vary greatly from individual to individual. In many cases, the pain subsides after a few weeks as the swelling subsides. In rare cases, the pain may persist beyond the treatment period and indicate long-term damage and wear and tear of the joint.