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Updated: Jun 16, 2026

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Radioscapholunate arthrodesis - a prospective study.

Gregory Ian Bain1, Phillip Ondimu, Peter Hallam

  • 1Department of Orthopaedic Surgery, Modbury Public Hospital, Modbury, South Australia, Australia. greg@gregbain.com.au

Hand Surgery : an International Journal Devoted to Hand and Upper Limb Surgery and Related Research : Journal of the Asia-Pacific Federation of Societies for Surgery of the Hand
|February 6, 2010
PubMed
Summary
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Radioscapholunate (RSL) arthrodesis with distal scaphoid excision and triquetrum resection effectively relieved pain and maintained patient function. This wrist fusion procedure resulted in minimal loss of motion and high patient satisfaction.

Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Musculoskeletal Research

Background:

  • Post-traumatic osteoarthritis, rheumatoid arthritis, and Kienböck's disease can severely impact wrist function.
  • Radioscapholunate (RSL) arthrodesis is a surgical procedure aimed at fusing the radioscaphoid and radiolunate joints.
  • Excision of the distal scaphoid and triquetrum may be performed in conjunction with RSL arthrodesis.

Purpose of the Study:

  • To evaluate pain levels, range of motion, patient activity, and satisfaction following RSL arthrodesis combined with distal scaphoid excision and triquetrum resection.
  • To assess the non-union rate of RSL arthrodesis and compare outcomes with existing literature.
  • To determine the functional and subjective outcomes of this combined surgical approach in patients with a functional midcarpal joint.

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Main Methods:

  • A prospective study involving 23 patients (14 males, 9 females; average age 47 years) who underwent RSL fusion.
  • Patients had post-traumatic osteoarthritis, rheumatoid arthritis, or Kienböck's disease, with a functional midcarpal joint confirmed pre- and intra-operatively.
  • Follow-up averaged 32 months, assessing pain (visual analogue scale), range of motion (flexion-extension, ulnoradial), patient activity, and satisfaction.

Main Results:

  • Average visual analogue pain scores significantly decreased from 64 to 28 (p=0.01).
  • Flexion-extension arc reduced slightly from 66 to 57 degrees, while ulnoradial arc increased from 22 to 43 degrees.
  • Nineteen patients experienced no activity restriction, and all but one reported satisfaction; all remained employed, with 10 returning to sports.

Conclusions:

  • RSL fusion with distal scaphoid excision and triquetrum resection provides significant pain relief and maintains patient function.
  • The procedure results in minimal reduction in the flexion-extension arc and an increase in the ulnoradial arc of motion.
  • This surgical technique demonstrates good outcomes regarding pain, function, and patient satisfaction, with a low non-union rate.