This 2011 current-concepts review by Strauch updates the evaluation and surgical management of SLAC and SNAC wrist — the two most common patterns of end-stage wrist arthritis. It covers etiology, diagnostic workup, and the full menu of surgical options, with particular focus on the ongoing PRC-versus-4-corner-arthrodesis debate and the role of circular plate fixation.
When evaluating a patient with apparent SLAC wrist, always obtain bilateral wrist x-rays — an asymptomatic contralateral SLAC pattern suggests CPPD rather than trauma and changes the workup.
When counseling patients on PRC versus 4-corner arthrodesis, both procedures deliver equivalent pain relief and strength; age and activity demand should drive the choice, not an assumption that fusion is superior.
This 2011 current-concepts review by Strauch updates the evaluation and surgical management of SLAC and SNAC wrist — the two most common patterns of end-stage wrist arthritis. It covers etiology, diagnostic workup, and the full menu of surgical options, with particular focus on the ongoing PRC-versus-4-corner-arthrodesis debate and the role of circular plate fixation.
When evaluating a patient with apparent SLAC wrist, always obtain bilateral wrist x-rays — an asymptomatic contralateral SLAC pattern suggests CPPD rather than trauma and changes the workup.
When counseling patients on PRC versus 4-corner arthrodesis, both procedures deliver equivalent pain relief and strength; age and activity demand should drive the choice, not an assumption that fusion is superior.