SLAC Wrist Surgery

Georgia Hand, Shoulder, and Elbow

Are you experiencing wrist pain even though you have no recollection of recently injuring yourself? If you have lingering pain within your wrist bones, you may have a condition called scapholunate advanced collapse (SLAC) wrist.

Our experts at Georgia Hand, Shoulder & Elbow have helped many recover from this condition! Sometimes, depending on the severity of the condition, surgical intervention may be needed. Schedule an appointment at our offices in Marietta or Atlanta, Georgia today to get a proper diagnosis of your wrist.

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What is a SLAC Wrist?

A SLAC wrist is the most common form of degenerative arthritis of the wrist joint. This condition can be very painful.

Within your wrist, you have two small bones called the scaphoid and lunate bones. These wrist bones are held tightly together by a strong band of tissue called the scapholunate ligament.

If you have a scapholunate ligament injury, your bones can become unstable, resulting in the very gradual development (often over months and years) of a specific type of wrist arthritis called wrist osteoarthritis. This condition can be very painful and reduces the functionality of your wrist and hand.

Another cause of arthritis in the wrist is scaphoid nonunion advanced collapse (SNAC) wrist. In this case, the scaphoid bone was fractured and never healed, causing a similar type of arthritis as a SLAC wrist. 

Scapholunate Advanced Collapse Wrist Causes

Scapholunate advanced collapse wrist can be caused by the following:

  • A tear in your scapholunate ligament
  • A wrist injury that you suffered in the past, such as a wrist sprain or wrist fracture
  • Midcarpal instability
  • Avascular necrosis of the scaphoid (occurs when the cells of your scaphoid bone die as a result of a lack of blood supply)
  • Kienböck disease (a condition in which the blood to the lunate bone is interrupted)

SLAC Wrist Symptoms

The most common symptoms experienced by those who have SLAC wrist include:

  • Pain on the thumb side of your wrist
  • Progressive weakness in the hand with the injury
  • Weak grip strength
  • Reduced range of motion
  • Difficulty bearing weight on your injured wrist
  • Stiffness
  • Your wrist being tender to the touch

How is a SLAC Wrist Diagnosed?

To accurately diagnose a SLAC wrist, your doctor will perform a physical examination of your wrist, and thoroughly review your symptoms and medical history. They may also use X-rays to confirm the diagnosis. While the torn ligament will not appear on the x-ray, your doctor will be able to see if any bones have shifted, as well as any SLAC wrist arthritis that may have developed.

Your doctor may also request an MRI or perform a wrist arthroscopy to get a detailed picture of the inside of your wrist. Additionally, your doctor may perform a Watson scaphoid shift test to confirm the diagnosis. This test allows your doctor to check your wrist to see if there has been any movement of your scaphoid bone.

Non-Surgical Treatment for SLAC Wrists

For some, if their SLAC wrist symptoms are mild, the following non-surgical treatments can be rendered:

  • Modifying your activity levels
  • Ceasing to participate in the activities that aggravate your injury
  • Wrist splinting
  • Anti-inflammatory medications to help reduce inflammation and ease your pain
  • Cortisone injections
  • Physical therapy exercises to strengthen muscles and increase range of motion

Surgical Treatment for SLAC Wrist

Surgical options for more severe cases of SLAC wrist may include:

  • SLAC Reconstruction: This wrist ligament reconstruction procedure involves repairing your torn ligament. Your surgeon will graft tissue from another tendon onto the damaged scapholunate ligament. After the tendon graft is complete, your surgeon may also decide to insert metal pins into your wrist for additional stabilization.
  • Proximal Row Carpectomy: During this procedure, the arthritic bones will be removed, but there is no fusion of the bones within your wrist
  • Partial or Total Wrist Arthrodesis: During a wrist arthrodesis procedure, your surgeon will fuse some or all of the bones in your wrist. 
  • Interpositional arthroplasty: During this procedure, your surgeon will remove some of the bones in the affected joint and replace it with local tissue.

All surgery will be performed with general anesthesia. After surgery, wearing a wrist brace or cast for a few weeks may be required to help keep your wrist immobilized. Your doctor may also recommend physical therapy to assist you in regaining full use of your wrist joint.

Get Help for Your Wrist Pain Today

Wrist pain can deeply impact various aspects of your life, and sometimes surgery is needed to correct the issue. Schedule an appointment with our expert team at Georgia Hand, Shoulder & Elbow in Marietta or Atlanta, GA to see if surgery is the right treatment option for you! We look forward to helping you get the quality care you deserve. 

Randall Alexander, MD

Hand & Orthopaedic Surgeon

Hand & Orthopaedic Surgeon

Hand & Plastic Surgeon

Hand & Orthopaedic Surgeon

Hand & Orthopaedic Surgeon

Hand & Orthopaedic Surgeon

Hand & Orthopaedic Surgeon

Hand & Orthopaedic Surgeon