Distal scaphoid excision after radioscaphoid arthrodesis

Range of Motion Effects of Distal Pole Scaphoid Excision and Triquetral Excision After Radioscapholunate Fusion: A Cadaver Study

“…Radioscapholunate (RSL) fusion is a particularly attractive option because it permanently obliterates the painful RSL joint while maintaining some wrist motion across the preserved midcarpal joint. [1][2][3] Although this retained motion, which typically averages 33% to 40% of normal, 1,2,4 is functionally useful, in our experience, patients are still frustrated by the limitations. Efforts to improve post-RSL fusion motion have included excision of the distal pole of the scaphoid.…”

Treatment of radiocarpal degenerative osteoarthritis by radioscapholunate arthrodesis and distal scaphoidectomy

“…17 With time, the resultant increased stress at the scaphoid-trapezium-trapezoid (STT) joint may cause painful midcarpal DJD. 9,17 We hypothesized that a distal scaphoidectomy could be beneficial in terms of less restriction of midcarpal motion, as recently shown in vitro by McCombe et al, 18 and consequently less residual pain and improved function.…”

Development and Validation of a Computational Model for Investigation of Wrist Biomechanics

“…Clinical studies have shown that, after RSL fusion, patients often develop midcarpal degenerative arthritis. 10,28 Subsequent scaphoid DP excision restores motion at the midcarpal joint, as previously shown, 4,26,27,33 by removing a strong lever arm that unloads the RSL arthrodesis so that fusion rates improve and secondary midcarpal arthritis decreases. Increases in force after RSL fusion can be seen at the scaphoid-trapezoid articulation in flexion (57% increase), the scaphoid-trapezoid (44% increase), and lunate-capitate (26% increase) articulations in extension, the scaphoid-trapezoid (33% increase), and lunate-capitate (64% increase) articulations in radial deviation, and the scaphoid-capitate articulation in ulnar deviation (31% increase).…”

“…4,26 McCombe analyzed the effects of distal scaphoid excision after radioscaphoid arthrodesis. Their preoperative flexion-extension arc (141°± 9) is very similar to our computational prediction (143°).…”