[Arthrodesis of the central support of the carpus. Indications, technic, results]

We have used this operation for the management of pain due to osteoarthritic changes at the radio-scaphoid and capitate-lunate joints. It allows correction of the carpal height by reposition of the flexed lunate, preserves the load bearing capitate-lunate axis, and decompresses the radio-scaphoid joint. We have carried out the procedure in 25 cases. Perilunate instability with osteoarthritic changes were present in 14 wrists; the remainder were consequent to non-union of fractures of the scaphoid with osteoarthrosis, or following complex fracture dislocations. At review 10 patients were free of pain, 12 had occasional pain and 3 were not improved. The mean residual range of movement in the wrist was 49 degrees, with a range from 20 degrees to 80 degrees. Bony union was not achieved in 5 wrists. At operation the lunate is reduced and carpal height restored with realignment of the weight bearing axis. Bone grafts and internal fixation are used.