Houston Methodist. Leading Medicine

Wrist FAQ

Question:

I'm trying to understand the kind of problem I'm having with my wrist. The surgeon wrote it down for me so I could go on-line and look it up. It's called: SNAC. Can you please explain what this is?

Answer:

The name scaphoid nonunion advanced collapse (SNAC) actually helps describe the condition. Scaphoid is a bone in the center of the wrist. It is a key player in providing flexible mobility of the wrist joint. A fracture of the scaphoid bone that doesn't heal is described as a nonunion. When the scaphoid is broken, it no longer stays in alignment. If one or both of the fractured pieces shifts (collapses), the joint becomes unstable. Trauma (like your drill press accident) is the main cause of this type of scaphoid collapse. Any trauma, injury, or other disease process that affects the scaphoid can also potentially affect the other bones (capitate, lunate, triquetrum, hamate) and ligaments in contact with the scaphoid. Damage (tears or ruptures) of the scapholunate ligament (between the scaphoid and lunate bones) puts the wrist at additional increased risk for uneven wear, joint degeneration, and wrist arthritis. That doesn't paint a very rosey picture for you. But the fact is that treatment for this condition can cause problems of its own. Studies have not been done to really nail down what's the best treatment for this problem. Each patient is treated on a case-by-case basis. Future studies comparing the results of each treatment method based on patient age, strength, activity level, and work requirements may help guide treatment decisions for this problem. With the information here, we hope you can go back to your surgeon and discuss what might be the best treatment approach for you. Robert J. Strauch, MD. Scapholunate Advanced Collapse and Scaphoid Nonunion Advanced Collapse Arthritis -- Update on Evaluation and Treatment. In The Journal of Hand Surgery. April 2011.

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