Distal scaphoid resection arthroplasty for the treatment of degenerative arthritis secondary to scaphoid nonunion

Distal Scaphoid Resection Arthroplasty for Scaphoid Nonunion With Radioscaphoid Arthritis

“…Our operative indication was scaphoid nonunion with symptomatic radioscaphoid arthritis without involvement of the lunocapitate joint. The same indication was presented by Ruch 4 and Malerich 8 in their studies. In-Ho 5 in 2003, however, also used this method to treat two patients Table 1.…”

“…The using of distal scaphoid resection arthroplasty for decompression of the radial side of the wrist to retain the radiocarpal joint and wrist stability, while eliminating current degenerative changes, for scaphoid nonunion was published by Ruch 4 in 1998 and subsequently by Malerich 8 in 1999. Theoretically, excision of the distal fragment eliminates the impingement symptoms caused by motion at the nonunion site and between the radial styloid and distal scaphoid 5 .…”

Osteoarthritis of the Wrist

“…One notable difference in between the treatment plans for SLAC and SNAC wrists is that the SNAC wrist can be treated with the excision of the distal scaphoid fragment. One study noted that 13 out of 19 patients showed significant pain relief as well as improved ROM and grip strength with this procedure (Malerich, Clifford et al 1999). In summary, a SNAC wrist injury shares a great deal with a SLAC wrist and is discerned through a careful history, physical, and radiographic evaluation.…”

“…Post operative follow up shows that patients generally have improved pain levels while maintaining ROM and grip strength. (Malerich, Clifford et al 1999)Although controversy remains with regard to the "best" procedure with which to treat a SLAC wrist, we are able to take solace in the fact that regardless of operative technique, patient satisfaction remains very high.…”

Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist arthritis

“…However, of 4 patients with capitolunate arthrosis, 2 had persistent symptoms, and 3 had progressive degenerative changes. The authors concluded that distal pole excision is an alternative to partial wrist arthrodesis [23]. Soejima et al reported that distal pole excision improved pain, strength, and ROM in patients with scaphoid nonunions.…”