Treatment of scapholunate advanced collapse by 3D-modelled scaphoid prostheses.

Abstract

A male patient in his 50s presented with severe bilateral wrist pain caused by scapholunate advanced collapse (SLAC). He did not wish to undergo a salvage treatment, and consecutively both affected scaphoids were replaced by 3D-modelled prostheses. 3 and 2 years postoperatively, the patient had significant pain reduction, good wrist function and grip strength. Final X-rays demonstrated no signs of dislocation of the implant or signs of periprosthetic arthritis. Studies have shown that once SLAC occurs, the treatment should consist of either a proximal row carpectomy or scaphoidectomy and four-corner fusion. In our case, despite collapse, replacement of the single affected bone by a 3D-modelled prosthesis led to good return of function.