Musculoskelet Surg. 2025 Dec 27. doi: 10.1007/s12306-025-00939-0. Online ahead of print.
ABSTRACT
Scapholunate advanced collapse (SLAC) and scaphoid non-union advanced collapse (SNAC) are well-recognised degenerative wrist conditions. Debate persists over optimal treatment, particularly since 4 corner fusion (4CF) emerged in the 1980s. Reviews have compared the outcomes of 4CF and PRC; however, none of these have looked at whether the initial diagnosis determines the final outcome. This systematic review hypothesises that the outcome of PRC and 4CF for the treatment of stage 2 and 3 SNAC and SLAC varies depending on the initial diagnosis. Searches of PubMed, Google Scholar and Cochrane database using the terms ‘SNAC’ and ‘SLAC’ were performed. Studies were excluded based on results recorded, study nature and whether results were separated according to the initial diagnosis. Studies were assimilated using weighted averages and further analysed using Microsoft Excel and GraphPad Prism software. A total of 3320 studies were identified; however, only 6 studies (8 study arms) were included. Of these, 7 study arms recorded pre- and post-operative range of movement data, 4 with pre- and post-operative disabilities of the arm, shoulder and hand (DASH) scores and 5 with pre- and post-operative Visual Analogue Score (VAS) pain scores. There was no statistical difference in these outcome measures with a mean follow-up of 62 months (38-120). This review found no significant difference in the outcomes of these procedures; however, there is a high level of uncertainty. Further studies should focus on reporting data by procedure as well as initial diagnosis with appropriate power calculations and should be designed as prospective randomised control trials.
PMID:41455026 | DOI:10.1007/s12306-025-00939-0
