Three-corner wrist fusion using memory staples

Scapholunate dissociation with advanced collapse (SLAC), scaphoid nonunion advanced collapse (SNAC), and lunotriquetral advanced collapse (LTAC) of the carpus are challenging problems. Various treatment options have been described. We describe a technique of 3-corner wrist fusion, using memory staples. The scaphoid and triquetrum are resected, and the capitate is fused to the lunate. Articular cartilage is removed from the capitolunate joint, and the bones are shaped to conforming surfaces. Bone graft from the resected triquetrum and scaphoid is used to increase fusion rate and a dynamic compressive fixation force is applied due to the unique properties of the memory staples. The main advantages of this procedure include the following: retained anatomical articulation between the lunate and the lunate fossa on the radius, improved ulnar deviation due to the resection of the triquetrum, and an excellent fusion rate between the lunate and capitate due to the dynamic fixation, the conforming surfaces, and the use of autologous bone graft.