Scaphoid non-union advanced collapse
Citation, DOI, disclosures and article data
Citation:
Sharma R, Jin R, Saber M, et al. Scaphoid non-union advanced collapse. Reference article, Radiopaedia.org (Accessed on 13 Feb 2025) https://doi.org/10.53347/rID-15201
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rID:
15201
Article created:
30 Sep 2011,
Imran Jindani
Disclosures:
At the time the article was created Imran Jindani had no recorded disclosures.
View Imran Jindani's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Rohit Sharma had no financial relationships to ineligible companies to disclose.
View Rohit Sharma's current disclosures
Revisions:
20 times, by
14 contributors -
see full revision history and disclosures
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Synonyms:
- Scaphoid nonunion advanced collapse
- SNAC
- Scaphoid non union advanced collapse (SNAC)
- SNAC wrist
Scaphoid non-union advanced collapse (SNAC) is a complication that can occur with scaphoid fractures, specifically non-union of scaphoid fractures. It is essentially the same sequela of wrist injury causing scapholunate dissociation as seen in scapholunate advanced collapse (SLAC).
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Pathology
In a SNAC wrist, the proximal scaphoid fragment usually remains attached to the lunate (which rotate together during extension), while the distal scaphoid fragment rotates into flexion. This results in abnormal contact in the radioscaphoid compartment, characterized by early styloid osteoarthritis between the distal scaphoid fragment and the radial styloid process.
Radiographic features
Radiographic signs will depend on the stages of osteoarthritis in a SNAC wrist 4:
-
stage 1
- osteoarthritis between the distal scaphoid fragment and the radial scaphoid fossa
-
stage 2
- same as stage 1 with the addition of osteoarthritis between the scaphoid and the capitate
-
stage 3
- osteoarthritis affecting the radial styloid, proximal scaphoid, and scaphocapitate with progression to the lunocapitate
- there is lateral proximal radial migration of the capitate dorsal to the lunate, which is a DISI configuration
- this is followed by non-articulation between the capitate and radius
Treatment and prognosis
Patients with advanced degenerative changes may undergo a four-corner fusion or proximal row carpectomy (PRC) for pain relief and some improvement in functionality.
See also
Quiz questions
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References
- 1. Vender MI, Watson HK, Wiener BD et-al. Degenerative change in symptomatic scaphoid nonunion. J Hand Surg Am. 1987;12 (4): 514-9. Pubmed citation
- 2. Tomaino MM, Miller RJ, Cole I et-al. Scapholunate advanced collapse wrist: proximal row carpectomy or limited wrist arthrodesis with scaphoid excision?. J Hand Surg Am. 1994;19 (1): 134-42. doi:10.1016/0363-5023(94)90237-2 - Pubmed citation
- 3. Strauch RJ. Scapholunate advanced collapse and scaphoid nonunion advanced collapse arthritis-update on evaluation and treatment. J Hand Surg Am. 2011;36 (4): 729-35. doi:10.1016/j.jhsa.2011.01.018 - Pubmed citation
- 4. Penteado FT, Dos Santos JB, Caporrino FA et-al. Scaphoid nonunion advanced collapse classifications: a reliability study. J Hand Microsurg. 2012;4 (1): 12-5. doi:10.1007/s12593-012-0062-2 - Free text at pubmed - Pubmed citation
- 5. Radiographic Patterns of Radiocarpal and Midcarpal Arthritis. (2017) Jaaos: Global Research and Reviews. 1 (3): e017. doi:10.5435/JAAOSGlobal-D-17-00017 - Pubmed
Incoming Links
Articles:
- Scaphoid non-union
- Wrist radiograph (checklist)
- Proximal row carpectomy
- Scaphoid
- Four-corner fusion (wrist)
- MRI of the wrist (an approach)
- Hand radiograph (checklist)
- Medical abbreviations and acronyms (S)
- Scapholunate advanced collapse
- Post-traumatic osteoarthritis
- Radioscaphoid angle
- Scaphoid fracture
Cases:
- Wrist arthrodesis
- Four-corner fusion (wrist)
- Scaphoid non union advanced collapse (SNAC)
- Scaphoid non union advanced collapse (SNAC)
- Scaphoid nonunion advanced collapse
- Scaphoid nonunion with humpback and DISI deformities
- Scaphoid non-union advanced collapse (SNAC)
- Scaphoid nonunion with humpback deformity
- Scaphoid non-union advanced collapse and dorsal intercalated segment instability
- Scaphoid non-union advanced collapse and dorsal intercalated segment instability
- Scaphoid nonunion advanced collapse
- Scaphoid non-union advanced collapse (SNAC wrist)
- Scapholunate advanced collapse and scaphoid non-union
- SNAC wrist
- Scaphoid non-union advanced collapse (SNAC wrist)
- Early scapholunate advanced collapse treated with scaphoidectomy and four-corner fusion
- Ununited scaphoid fracture with dorsal intercalated segment instability and scaphoid non union advanced collapse
- Scaphoid non union advanced collapse
- Scaphoid non union advanced collapse
Multiple choice questions:
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