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In part based on these concerns, some surgeon prefer to maintain the lunate in patients younger than 40 years proximal row carpectomy. [6] [18] A surgery called four-corner arthrodesis is an option. [6] The capitate, lunate, hamate and triquetrum are fused together in this procedure and the scaphoid is excised.
The scaphoid can be slow to heal because of the limited circulation to the bone. Fractures of the scaphoid must be recognized and treated quickly, as prompt treatment by immobilization or surgical fixation increases the likelihood of the bone healing in anatomic alignment, thus avoiding mal-union or non-union. [6] Delays may compromise healing.
The capitate is the largest carpal bone found within the hand. [2] The capitate is found within the distal row of carpal bones. The capitate lies directly adjacent to the metacarpal of the ring finger on its distal surface, has the hamate on its ulnar surface and trapezoid on its radial surface, and abuts the lunate and scaphoid proximally.
The cavity of the midcarpal joint is very extensive and irregular. The major portion of the cavity is located between the distal surfaces of the scaphoid, lunate, and triquetrum and proximal surfaces of the four bones of the distal row. Proximal prolongations of the cavity occur between the scaphoid and lunate and between the lunate and triquetrum.
The management and treatment of SLAC wrist depends on the stage at the time of diagnosis. The options for management can be separated into two broad categories: non-surgical and surgical. Less advanced SLAC wrist may be managed initially with non-surgical options including nonsteroidal anti-inflammatory drugs , wrist splinting , and steroid ...
To perform the test, the examiner grasps the wrist with their thumb over the scaphoid tubercle (volar aspect of the palm) in order to prevent the scaphoid from moving into its more vertically oriented position in ulnar deviation. For the test, the wrist needs to be in slight extension. The patient's wrist is then moved from ulnar to radial ...
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