Radial styloid impingement after triscaphe arthrodesis

Painful radial styloid impingement after a successful triscaphe arthrodesis has been seen a number of times in a review of our patients undertaken to study this problem. Ninety-one patients with 93 triscaphe arthrodeses were seen at an average of 23 months after operation. Thirty-one patients (33%) were believed to have radial styloid impingement characterized by radial side pain on wrist flexion or limitation of motion in radial deviation. Average time of presentation was 19 months. Patients who had rotary subluxation of the scaphoid tended to develop impingement more frequently than those whose operation was done for treatment of degenerative arthritis or avascular necrosis of the lunate. Seventeen patients (18%) subsequently had a partial radial styloidectomy for treatment of this impingement. On the basis of these findings we now incorporate a partial radial styloidectomy as a routine procedure during a triscaphe arthrodesis.