Treatment of scaphotrapezial trapezoidal osteoarthritis with resection of the distal pole of the scaphoid

Abstract

Application of a pyrocarbon implant appears to be useful for pain relief and may help prevent secondary deformities in the treatment of scaphotrapezial trapezoidal arthritis.

Distal Pole Resection of the Scaphoid for the Treatment of Scaphotrapeziotrapezoid Osteoarthritis

“…Several authors report satisfactory pain reduction (less than 2.5 on a 0-10 scale) after distal pole resection of the scaphoid. 8,12,14 In accordance with these studies, our patients reported an average pain score of 2.1 on a 0 to 10 scale. In general, STT arthrodesis also results in good pain relief, with only 5% of patients reporting mild postoperative pain.…”

“…All studies reporting on distal pole resection of the scaphoid describe an increase of the radiolunate angle 5,8,12,13,16,17 postoperatively. In 3 studies, 8,16,14 this increase is reported to be statistically significant. Although patients do well on the short-term and midterm follow-up evaluations and the significance of these findings are unclear, they remain a cause of concern on the long term.…”

“…4,5,8,15 Potentially, however, resection of the distal pole of the scaphoid could cause the development of dorsal intercalated segment instability (DISI) deformity of the wrist or worsening of the DISI deformity if already present before surgery. 13 In addition, very few studies report on the outcome of this treatment for STT-OA 8,14 or nonunion of fractures of the distal part of the scaphoid. 5,12,13,16,17 The purpose of this study is to evaluate the midterm outcomes in a consecutive series of patients with STT-OA, using the following hypothesis: distal pole resection of the scaphoid is a good alternative for STT arthrodesis in the treatment of isolated STT-OA, with obvious advantages: easier technique, less downtime for patient, better range of motion (ROM), and less complications.…”

Current Trends in Operative Treatment of Scaphotrapeziotrapezoid Osteoarthritis: A Survey among European Hand Surgeons

“…17,18 The occurrence of a static or dynamic DISI pattern of carpal instability as a result of distal scaphoid resection has been reported in several studies. 15,16,19 Tendon interposition did not to affect the degree of DISI deformity. 16 Patients without fibrous interposition after distal scaphoid excision showed significantly greater wrist flexionextension motion than patients with soft-tissue interposition.…”

“…6 A Pyrocarbon implant to fill the gap may help to prevent carpal instability. 19 In this survey, implant arthroplasty was mainly performed in France. Compared with distal scaphoid excision, the main advantage of this procedure is that it retains scaphotrapezial mobility without destabilizing the carpal bones.…”