Radioscapholunate arthrodesis

Although RSL fusion is a viable option for isolated radiocarpal arthritis, the enthusiasm for this procedure should be tempered with the reality that kinematics of the wrist is not entirely suited for independent midcarpal flexion and extension [10]. Limited wrist flexion and extension is expected following a successful RSL arthrodesis. The effects of imposed abnormal kinematics are further shown by the high incidence of RSL nonunions, occurrence of scaphoid fractures, and postoperative deterioration of the midcarpal joint [15,22]. In a young patient with posttraumatic arthritis or rheumatoid arthritis limited to the radiocarpal joint, however, RSL arthrodesis remains a viable alternative to complete wrist arthrodesis if the midcarpal joint is normal. Internal fixation with plates and screws and distal scaphoid excision are technical alternatives to consider when an RSL arthrodesis is performed.