Outcomes Associated With Scapholunate Ligament Injury Following Intra-Articular Distal Radius Fractures

Purpose The purpose of this study was to evaluate a series of intra-articular distal radius fractures (DRFs) to determine whether patients without radiographic evidence of scapholunate (SL) ligament injury have a difference in outcomes in comparison with patients with radiographic evidence of SL ligament injury and no ligament repair or reconstruction. Our hypothesis is that there are no significant differences in outcomes between patients after treatment of their intra-articular DRF. Methods A retrospective analysis of patients from a single institution who sustained an intraarticular DRF from January 2006 through January 2019 with minimum 12-month (n = 192) and 24-month (n = 100) follow-up was performed. Patient demographic, clinical, and outcome variables were compared between SL angles less than 70 degrees (cohort 1) and SL angles 70 degrees or greater (cohort 2). Radiographic parameters were measured and recorded at 3 time points: baseline in the contralateral wrist, following closed reduction but prior to surgical intervention, and at final follow-up. Outcomes collected included Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Modified Global Assessment of Function (mGAF), and a visual analog scale (VAS) for pain. Results One hundred ninety-two patients were included. Of these 192 patients, cohort 1 (n = 110) was observed to have median (range) SL angles of 58 degrees (42 degrees e68 degrees) and cohort 2 (n = 82) median (range) SL angles of 74.5 degrees (70 degrees-87 degrees) after closed reduction. Cohort 2 had statistically significant increases in median SL angles from closed reduction to final follow-up (74.5 degrees [range, 70 degrees-87 degrees) to 78.5 degrees (range, 71 degrees-107 degrees). There were no statistically significant differences in QuickDASH disability scores, mGAF scores, and VAS pain scores between the cohorts at initial and final follow-ups. Conclusions Patient-reported outcomes at 12 and 24 months do not differ between patients without radiographically apparent SL ligament injury (SL angles < 70 degrees) and patients with radiographically apparent SL ligament injury(SL angles < 70 degrees) who do not undergo ligament repair or reconstruction following treatment of their intra-articular DRF. Copyright (C) 2021 by the American Society for Surgery of the Hand. All rights reserved.)