Capitolunate Arthrodesis for Treatment of Scaphoid Nonunion Advanced Collapse (SNAC) Wrist Arthritis

The aim of the study was to evaluate results of capitolunate arthrodesis for the treatment of post traumatic degenerative SNAC wrist disorders. A capitolunate arthrodesis was performed on 12 patients, three women and nine men, of 44 years in average (28-66 years). Ten patients were manual workers; dominant side was involved in seven cases with no history of previous operation. Fixation of the arthrodesis was performed with headless compression screws. Patients were reviewed at 37.4 months of average follow up (range; 12-47 months). Mayo score equal to 82.8 points. Radiolunate and capitolunate angles were decreased of 6 and 8° respectively at the final follow up radiograph compared to preoperative values. The Ten manual worker patients were able to return to their previous professional activities and the other two patients were retired but they resume their sports and recreational activities. With the advent of headless compression screws the capitolunate arthrodesis gained a higher union rate, short operative time and short rehabilitation period. In the present study the capitolunate arthrodesis allowed restoring a stable functional wrist in the 12 patients reviewed. It is a satisfactory therapeutic alternative to four corners fusion for SNAC wrist with osteoarthritis.