Proximal row fusion as a solution for radiocarpal arthritis

A retrospective study evaluated the function of thirty-six patients treated by radius-scaphoid-lunate arthrodesis for painful posttraumatic radiocarpal arthritis from 1982 through 1987, and determined whether the procedure created arthritis or other functional problems in the remaining joints. Thirty-one men and five women with a mean age of 41 years were studied. The standard surgical technique employed iliac crest bone graft and internal fixation. Seven patients required revision of the proximal fusion to complete wrist fusion because of pain; arthritic changes in the midcarpal joint had been noted in these patients at the time of the limited fusion. The remaining twenty-nine patients required no further surgical treatment. Grip strength averaged 70% of the uninvolved side. The average arc of wrist flexion and extension was forty-eight degrees. Eighteen patients returned to their original employment, in many cases to heavy labor. Five did not return to work because of wrist problems. We conclude that the probability of a good functional result is high for this procedure if there is no midcarpal arthritis.