Scaphoid non-union advanced collapse (SNAC wrist)

Case contributed by Samir Benoudina


Known case of old pseudarthorsis of scaphoid. Pain increasing these last weeks.

Patient Data

Age: 55
Gender: Male

Frontal view:

  • Osteoarthritis affecting the radial styloid and the scaphoid, with narrowing of the radioscaphoid joint space and associated subchondral sclerosis and cyst formation.
  • Osteoarthritis with narowwing of the lunocapitate joint space (Snac stage III), due to proximal migration of the capitate.
  • Ulnar translation of lunate.

Lateral view:

Features consistent with SNAC wrist stage III, with DISI.


Frontal view:

  • Yellow arrows: Radial styloid and scaphoid OA
  • Black arrow: narrowing of the lunocapitate joint space, due to proximal migration of the capitate.
  • Red arrow: Ulnar translation of lunate.

Lateral view:


Case Discussion

Scaphoid nonunion advanced collapse (SNAC) and scapholunate advanced collapse (SLAC) are the two most common patterns of posttraumatic wrist arthritis.

SNAC wrist is due to a non-united scaphoid fracture.

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