Scapholunate Advanced Collapse: Four-Corner Fusion and Proximal Row Carpectomy

In athletes, scapholunate injuries may be misdiagnosed as wrist sprains which over time almost invariably lead to scapholunate advanced collapse (SLAC) of the wrist. In this setting, arthritic changes progress from the radioscaphoid joint to the lunocapitate interval, usually preserving the radiolunate articulation. Treatment options for SLAC range from nonoperative alternatives to wrist denervation, limited intercarpal fusions, proximal row carpectomy, and total wrist fusion. This article describes four-corner fusion and proximal row carpectomy as 2 widely used and successful options for the management of SLAC.