Radiolunate and radioscapholunate arthrodesis

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Wrist Arthodesis

Background:

• Wrist arthritis and posttraumatic changes can significantly impair function.
• Rheumatoid arthritis is a common cause of wrist disease, but other etiologies exist.
• Limited arthritis or posttraumatic changes affecting the radiocarpal joint necessitate specific surgical interventions.

Purpose of the Study:

• To evaluate the outcomes of radiocarpal arthrodesis in patients with wrist disease other than rheumatoid arthritis.
• To assess the efficacy of radiolunate and radioscapholunate fusions for various wrist pathologies.
• To determine the functional recovery, pain relief, and union rates following radiocarpal arthrodesis.

Main Methods:

• Retrospective review of eleven patients undergoing radiocarpal arthrodesis.
• Procedures included seven radiolunate fusions and four radioscapholunate fusions.
• Indications comprised posttraumatic changes, Kienböck's disease, post-septic arthritis, and distal radius fractures.

Main Results:

• All eleven patients achieved bony union.
• Postoperative wrist range of motion averaged: 30.9° extension, 22.7° flexion, 10° radial deviation, 19.3° ulnar deviation.
• Grip strength averaged 81.8% of the uninvolved hand, with complete pain relief and return to occupation for all patients.

Conclusions:

• Radiocarpal arthrodesis is a successful treatment for specific wrist conditions, excluding rheumatoid arthritis.
• The procedure provides significant pain relief, functional restoration, and high rates of bony union.
• No degenerative changes were observed in the midcarpal joint postoperatively, suggesting joint preservation.