Scaphoid excision with lunatocapitate fusion for the treatment of scaphoid nonunion with advanced collapsed wrist

Abdelaziz, Ashraf M; Aldahshan, Wael; Elsherief, Faisal Ahmed Hashem; Wahd, Yaser El Sayed Hassan; Soliman, Hany Abdel Gawwad; Behairy, Hassan Fathy El; Ismail, Magda M. F.

doi:10.1007/s00264-020-04570-5

Cited by 12 publications

(16 citation statements)

References 17 publications

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“…In a series of 15 patients, they found mean postoperative flexion-extension arc was 70.1 degrees and grip strength was 71.5% of the contralateral side. 10 There were 2 cases of nonunion (13.3%) requiring revision, which subsequently went on to union, and 3 cases of ulnar sided wrist pain presumably secondary to the authors not fusion or excising the triquetrum. 10 In a large systematic review of capitolunate arthrodeses, Dunn et al 7 report mean postoperative flexion-extension arc of 71.3 degrees, grip strength to improve by 34.2% from pre- to postoperatively, and a 96.3% union rate.…”

Section: Discussionmentioning

confidence: 93%

“…10 There were 2 cases of nonunion (13.3%) requiring revision, which subsequently went on to union, and 3 cases of ulnar sided wrist pain presumably secondary to the authors not fusion or excising the triquetrum. 10 In a large systematic review of capitolunate arthrodeses, Dunn et al 7 report mean postoperative flexion-extension arc of 71.3 degrees, grip strength to improve by 34.2% from pre- to postoperatively, and a 96.3% union rate. Four of these patients (5%) underwent conversion to wrist arthrodesis, 6.25% required hardware removal, and 1.25% had revision surgery for bone grafting and arthrodesis.…”

Section: Discussionmentioning

confidence: 93%

“…There have been other limited intercarpal arthrodeses techniques described as an alternative to FCA, including variations of the bicolumnar arthrodesis, lunatocapitate arthrodesis with scaphoid excision, and capitolunate arthrodeses with or without triquetrum excision. 7,9,10 Draeger et al 9 describe their technique of bicolumnar arthrodesis, which involves scaphoidectomy with antegrade headless screw fixation of the lunate-capitate and triquetrum-hamate-capitate joints. In a small series of 11 patients, they observed a mean 88 degrees of flexion-extension arc postoperatively (68% of the contralateral side), and postoperative grip strength was 97% of the contralateral side.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Subsequently, a number of limited carpal arthrodeses have been proposed, with the central rationale suggesting that the fusion of fewer carpal bones leads to similar outcomes with a smaller surgical footprint and fewer complications. [7][8][9][10] One such technique, as described by Wang and Bednar in 2012, involves scaphoidectomy and a 2 column fusion between the lunatocapitate and triquetrohamate articulations. 8 Headless compression screws are used to facilitate fusion between the capitate and lunate as well as the hamate and triquetrum, augmented with autologous bone graft taken from the excised scaphoid.…”

Section: Introductionmentioning

confidence: 99%

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Lunatocapitate and Triquetrohamate Arthrodeses for Degenerative Arthritis of the Wrist: A Midterm Follow-Up

Schindelar

Wang

Bednar

et al. 2022

Hand (New York, N,Y.)

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Background: Degenerative arthritis of the wrist is a common condition often treated with 4 corner arthrodesis (FCA) or a partial wrist fusion. A number of limited intercarpal arthrodeses have been proposed for treatment of this condition. One technique, described by Wang and Bednar in 2012, involves fusion of the lunatocapitate and triquetrohamate joints. This study presents midterm follow-up of outcomes following this 2 column arthrodesis. Methods: From 2000 to present, patients who underwent lunatocapitate and triquetrohamate arthrodesis were evaluated. The original cohort from the 2012 study was reviewed, as well as any additional patients who since underwent this procedure. Only patients who had greater than 5 years of follow-up data were included. Outcomes included demographics, wrist range of motion, grip strength, complications, and radiographic evidence of union. Results: Twenty-one cases were included in the final analysis. Mean follow-up was 8.75 years. Wrist extension and flexion were 58% and 90% of the unaffected side, respectively. Grip strength was 92% of the unaffected side. Osseous union was achieved in 95.2% of cases. Two cases underwent revision surgery, one for nonunion and one following a fall. Conclusions: Lunatocapitate and triquetrohamate arthrodesis offers a treatment for wrist arthritis that yields good clinical outcomes, low nonunion rates, and no conversions to total wrist arthrodesis, as shown by 5-year follow-up data. Limited intercarpal arthrodesis is an alternative to FCA, with the advantage of a smaller surgical footprint and simpler technique, while still providing excellent mid- to long-term outcomes.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lunatocapitate and Triquetrohamate Arthrodeses for Degenerative Arthritis of the Wrist: A Midterm Follow-Up

Schindelar

Wang

Bednar

et al. 2022

Hand (New York, N,Y.)

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“…Scaphoid nonunion, if not treated, can lead to a scaphoid nonunion advances collapse (SNAC) and progressed degenerate changes. In that cases, different surgical options are available, such partial fusion [25] and proximal row carpectomy [26].…”

Section: Introductionmentioning

confidence: 99%

Pedicled vascularized bone grafts compared with xenografts in the treatment of scaphoid nonunion

Matić

Vuckovic²,

Lešić

et al. 2020

International Orthopaedics (SICOT)

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Introduction Fractures of the scaphoid account for 60-70% of all wrist bone fractures. The results of treatment in terms of bone healing vary depending on the type and location of the fracture, the time elapsed since the injury, the type of surgical treatment. Nonunion occurs in 5-15% of the cases on average. The purpose of this paper is to compare the surgical techniques and results of treating scaphoid nonunion (SNU) with osteoplastic xenografts of bovine origin or a vascularized autograft of the distal part of the dorsal radius. Methods We compare two groups of patients with symptomatic SNU, treated surgically with either a vascularized graft (n = 15) or a xenograft of bovine origin (n = 15). In the presurgical stage, the demographic characteristics of the patients, the time elapsed between injury and surgery, and classification of the injury (Schonberg, Herbert-Fisher, and Geissler-Slade) were recorded. One year following surgery, bone healing, total duration of the treatment, complications, the Mayo wrist score, and answers to the DASH questionnaire were analyzed.Results No statistically significant differences between the two groups of patients were observed for bone healing (86.7% vs 80%) or functional results. A highly significant difference was observed with respect to duration of the surgical intervention in favor of xenografts. Conclusion The xenograft method is simple and relatively acceptable, providing good results in terms of healing and functionality.

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Three-corner arthrodesis for scapholunate and scaphoid nonunion advanced collapsed wrists: outcomes at long term follow-ups

Delamarre,

Chantelot,

Saab

2024

Injury

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Scaphoid excision with lunatocapitate fusion for the treatment of scaphoid nonunion with advanced collapsed wrist

Cited by 12 publications

References 17 publications

Lunatocapitate and Triquetrohamate Arthrodeses for Degenerative Arthritis of the Wrist: A Midterm Follow-Up

Lunatocapitate and Triquetrohamate Arthrodeses for Degenerative Arthritis of the Wrist: A Midterm Follow-Up

Pedicled vascularized bone grafts compared with xenografts in the treatment of scaphoid nonunion

Three-corner arthrodesis for scapholunate and scaphoid nonunion advanced collapsed wrists: outcomes at long term follow-ups

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