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Scaphocapitate intercarpal arthrodesis.

S M Pisano1, C A Peimer, D R Wheeler

  • 1Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York.

The Journal of Hand Surgery
|March 1, 1991
PubMed
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Scaphocapitate arthrodesis can treat wrist instability and nonunion, but results show significant motion loss and persistent pain in some patients. Functional outcomes vary, with some patients experiencing limitations in daily activities and work.

Area of Science:

  • Orthopedics
  • Hand Surgery
  • Musculoskeletal Research

Background:

  • Scaphocapitate arthrodesis is a surgical procedure used for various wrist conditions.
  • Indications include rotary scaphoid instability, isolated arthrosis, scaphoid nonunion, and Kienböck's disease prevention.
  • Autogenous bone grafting is employed to facilitate fusion across carpal spaces.

Purpose of the Study:

  • To evaluate the long-term outcomes of scaphocapitate arthrodesis.
  • To assess functional recovery, range of motion, and pain levels post-surgery.
  • To identify potential complications and their impact on patient function.

Main Methods:

  • A retrospective reexamination of 17 patients who underwent scaphocapitate arthrodesis.
  • Follow-up ranged from 16 to 57 months (average 23.4 months).

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  • Assessment included range of motion, grip strength, and patient-reported pain and function.

    • Main Results:

    • Two cases of scaphocapitate arthrodesis nonunion required reoperation.
    • Seven patients reported persistent pain with heavy use, leading to occupation changes or disability in some.
    • Significant reductions in wrist motion were observed, particularly radial deviation. Static grip strength averaged 74% of the contralateral side, while dynamic power and endurance showed better recovery.

    Conclusions:

    • Scaphocapitate arthrodesis can achieve fusion but is associated with substantial loss of wrist motion and potential for persistent pain.
    • Functional outcomes are variable, with implications for patient occupation and daily activities.
    • Careful patient selection and expectation management are crucial for scaphocapitate arthrodesis outcomes.