Strauch Robert J
Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY 10032, USA.
J Hand Surg Am. 2011 Apr;36(4):729-35. doi: 10.1016/j.jhsa.2011.01.018.
Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse are common patterns of wrist arthritis. Scaphoid nonunion advanced collapse is caused by trauma, whereas SLAC wrist may also result from chronic pseudogout and can appear bilaterally without a clear history of injury. Surgical treatment for SLAC wrist includes 4-corner arthrodesis, capitolunate arthrodesis, complete wrist arthrodesis, proximal row carpectomy (PRC), denervation, and radial styloidectomy. Scaphoid nonunion advanced collapse wrist has the additional surgical option of excision of the distal ununited scaphoid fragment. Controversy persists over the relative merits of PRC versus 4-corner arthrodesis and whether PRC may be performed in the setting of capitate arthritis.
舟月骨高级塌陷（SLAC）和舟骨不愈合高级塌陷是腕关节关节炎的常见类型。舟骨不愈合高级塌陷由创伤引起，而SLAC腕关节也可能由慢性假痛风导致，并且可双侧出现，无明确损伤史。SLAC腕关节的手术治疗包括四角融合术、头月关节融合术、全腕关节融合术、近排腕骨切除术（PRC）、去神经术和桡骨茎突切除术。舟骨不愈合高级塌陷腕关节还有额外的手术选择，即切除远端未愈合的舟骨碎片。PRC与四角融合术的相对优点以及PRC是否可在头状骨关节炎的情况下进行仍存在争议。
