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Wrist: scaphoid pseudarthrosis (SNAC)

Introduction to scaphoid pseudarthrosis

Scaphoid pseudarthrosis with progressive collapse (SNAC-Wrist) is a degenerative condition that occurs when an untreated or improperly healed scaphoid fracture leads to chronic instability. The scaphoid is a crucial bone for the stability and function of the wrist.

If a fracture does not heal, it causes persistent pain, instability and eventually osteoarthritis. Fortunately, modern surgical techniques such as bone grafting and arthrodesis offer effective treatment options to restore function and relieve pain.

Wrist: scaphoid pseudarthrosis

Definition and stages of scaphoid pseudarthrosis

Definition of

Scaphoid pseudarthrosis occurs when a scaphoid fracture does not heal properly, leaving a permanent gap or misalignment between the bone fragments. Without treatment, this condition can lead to SNAC wrist, characterized by osteoarthritis and structural deterioration of the wrist.

Stages of SNAC-Wrist

The disease develops in three defined stages:

  • Stage I: First arthrosis between the scaphoid and the radius.
  • Stage II: Arthritic changes spread to the metacarpophalangeal joint.
  • Stage III: Complete joint collapse with severe pain and loss of function.
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Causes and risk factors

Various factors contribute to the development of scaphoid pseudarthrosis, including

  • Inadequate initial treatment - Delayed diagnosis or inadequate immobilization.
  • Poor blood supply - The scaphoid has a restricted blood supply, which increases the risk of avascular necrosis.
  • Smoking - Significantly reduces bone healing.
  • High-energy injuries - falls on the outstretched hand can cause complicated fractures that are difficult to heal.

A wrist prosthesis involves replacing the damaged joint with an artificial implant. This method is particularly suitable for patients who want to maintain their wrist mobility.

Symptoms and diagnosis

Symptoms

Patients with SNAC-Wrist often show

  • Chronic pain in the wrist
  • Reduced grip strength
  • Limited mobility
  • Swelling and stiffness

Diagnosis

The following imaging procedures are used for diagnosis:

  • X-ray - To assess the fracture position and arthritic changes.
  • MRI/CT - To analyze bone vitality and joint condition.

Treatment options for scaphoid pseudarthrosis

Bone grafting

Bone grafting is a surgical procedure to restore bone continuity and promote healing. There are two main types:

  • Vascularized bone grafting - A piece of bone with its own blood supply is transplanted to increase the chances of recovery.
  • Non-vascularized bone grafting - A piece of bone (e.g. from the iliac crest) is used to fill the fracture gap.

Arthrodesis (joint fusion)

In advanced cases, a wrist fusion (arthrodesis) can eliminate pain and stabilize the wrist. This procedure includes

  • Removal of the damaged cartilage
  • Fixation of the bones with screws or plates
  • Stiffening of the wrist to eliminate pain

Advantages of these treatment methods compared to alternatives

  • Preservation of wrist function - In contrast to complete fusion, bone grafting or partial fusion allow a certain degree of mobility.
  • Pain relief - Both procedures significantly reduce chronic pain.
  • Prevents further degeneration - Stops the progression of SNAC-Wrist and protects joint health.

Who can benefit from these processes?

Patients who can benefit from a bone graft or arthrodesis:

  • People with chronic scaphoid pseudarthrosis
  • Patients with wrist osteoarthritis due to SNAC-Wrist
  • People with limited wrist function in everyday life
  • Patients who prefer a joint-preserving procedure to a complete fusion
Are you suffering from scaphoid pseudarthrosis and looking for a specialist?
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Success rates and case studies

Studies show a high success rate for the treatment of scaphoid pseudarthrosis:

  • Bone grafting has a high healing rate, especially with vascularized grafts.
  • Arthrodesis provides long-term pain relief and functional stability, especially in severe cases.

Frequently asked questions

Persistent wrist pain, reduced grip strength, swelling and restricted movement are typical symptoms.

X-rays, MRI or CT are used to assess the healing status of the bone and the progression of osteoarthritis.

Full recovery usually takes 3-6 months, depending on the severity of the disease and postoperative rehabilitation.

Yes, an arthrodesis stiffens the wrist permanently, but eliminates the pain and provides stability.

I offer advanced treatments for SNAC-Wrist in Vienna. Please contact me for a consultation.

Contact information and next steps

If you suffer from wrist pain and suspect scaphoid pseudarthrosis, arrange a consultation at my practice in Vienna. Early treatment can prevent further damage and improve your quality of life.

The following languages are spoken in my ordination:

German, English, French, Russian, Slovak, Czech

My ordination in 1190 Vienna
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