Abstract
Although articular chondrocalcinosis is a frequently seen disorder, the broad clinical variations of forms affecting the wrist are more recently and more rarely described. Chondrocalcinosis of the wrist is an evolutionary disorder, which can initially be well treated medically. Further in the natural evolution, scaphoradial joint destruction occurs followed by midcarpal wear. Until now one form of chondrocalcinosis, developing scapholunate dissociation and tending towards a SLAC (Scapho-Lunate Advanced Collapse) wrist, has been well documented.
We state that there exists a pathway which does not lead to any scapholunate gap and is less often associated with a ST (Scapho-Trapezium) osteoarthritis. This isolated form of chondrocalcinosis of the wrist has been mistaken for SLAC or SNAC (Scaphoid Non-union Advanced Collapse) wrists, because its clinical and radiological resemblance. We propose to call this form the SCAC (Scaphoid Chondrocalcinosis Advanced Collapse) wrist. It is seen in elderly patients. There is a long evolution for several years, and most patients have an extensive medical history before the correct diagnosis is being made.
We describe the typical clinical and radiological evolution on five patients. According to the amount and pattern of cartilage destruction we propose a radiological classification in four grades. The five cases presented were all seen in grade III.
Two of them underwent previous surgery; a styloidectomy in one and a scaphoid replacement by a titanium prosthesis in the other. Three patients had previous carpal tunnel release. All five have been treated by a hamatoluno-capitate arthrodesis, with resection of the scaphoid and triquetrum (according to Delattre’s technique). Results are described and discussed.
The abstracts were prepared by Orah Naor. Correspondence should be addressed to him at the Israel Orthopaedic Association, PO Box 7845, Haifa 31074, Israel.
