Capitolunate arthrodesis with scaphoid and triquetrum excision

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Research

Background:

• Scapholunate advanced collapse (SLAC) arthritis significantly impairs wrist function.
• Surgical management aims to restore stability and alleviate pain while preserving function.
• Capitolunate arthrodesis with scaphoid and triquetrum excision is one such reconstructive option.

Purpose of the Study:

• To evaluate the clinical outcomes of capitolunate arthrodesis with scaphoid and triquetrum excision.
• To assess functional recovery and patient-reported outcomes in patients with SLAC arthritis.
• To compare the efficacy of this procedure against other motion-preserving surgical alternatives.

Main Methods:

• Retrospective, two-center outcome study.
• Inclusion of 14 patients (all male, average age 49) undergoing capitolunate arthrodesis with scaphoid and triquetrum excision for SLAC arthritis.
• Objective assessment using range of motion and strength measurements; subjective assessment via Short Musculoskeletal Functional Assessment (SMFA).

Main Results:

• Average follow-up of 28 months (range, 14-51 months).
• Grip and pinch strength recovery to 71% and 75% of contralateral wrists, respectively.
• Postoperative motion: 53° flexion-extension, 18° radioulnar deviation. Complications included nonunion (2 patients) and persistent pain (1 patient).

Conclusions:

• Capitolunate arthrodesis with scaphoid and triquetrum excision provides functional outcomes comparable to other motion-preserving procedures for SLAC arthritis.
• The procedure demonstrates potential for significant pain relief and functional restoration.
• Further investigation may be warranted to optimize outcomes and minimize complications.