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DOI: 10.1055/s-0044-1793923
Dorsoradial Wrist Bump: Disappearance of the Snuffbox as a Sign of “SLAC”
Article in several languages: español | English
Abstract
The anatomical snuffbox, a triangular region on the dorsoradial wrist, is a key anatomical landmark. Bordered by the tendons of the extensor pollicis longus, brevis, and abductor pollicis longus, it houses the radial artery and nerve branches. Pathologies such as synovial cysts, fractures, and osteophytes can alter its appearance. Studies on scapholunate ligament (SLL) injuries show that chronic damage causes the scaphoid to shift dorsoradially, initiating a degenerative process known as scapholunate advanced collapse (SLAC). This often results in the “disappearance” of the anatomical snuffbox, aiding in the identification of SLAC wrist patients alongside symptoms like pain and stiffness. The condition is driven by osteophyte formation, scaphoid subluxation, and synovitis, leading to joint instability and deformity. Traditional treatments, such as styloidectomy, may not fully address the instability. New approaches that consider the 3D wrist dynamics may be more effective in managing SLAC. Biomechanical studies suggest that SLL injuries, coupled with the loss of secondary stabilizers, cause the scaphoid to pronate and flex, resulting in a dorsal radial projection within the scaphoid fossa. Left untreated, this can progress to SLAC, often marked by the “dorsoradial wrist bump.”
Publication History
Received: 15 September 2024
Accepted: 16 October 2024
Article published online:
23 December 2024
© 2024. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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