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Changes in Wrist Motion After Simulated Scapholunate Arthrodesis: A Cadaveric Study
Kevin D Han1, Jaehon M Kim1, Michael V DeFazio1
1Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
The Journal of Hand Surgery
|August 30, 2016
Summary
Scapholunate (SL) arthrodesis via headless screw fixation showed minimal impact on wrist range of motion (ROM) in cadavers. This suggests SL arthrodesis may be a viable option for SL instability with limited adverse effects.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Hand Surgery
Background:
- Scapholunate (SL) instability often leads to poor outcomes with current fixation techniques.
- Arthrodesis of the SL joint has been limited due to concerns about functional range of motion (ROM).
Purpose of the Study:
- To evaluate the impact of simulated SL arthrodesis using headless screw fixation on wrist range of motion (ROM).
Main Methods:
- Baseline wrist ROM was measured in 10 cadaveric wrists.
- Simulated SL arthrodesis was performed using two 3.0-mm headless compression screws.
- Post-arthrodesis ROM was assessed using goniometry and fluoroscopic imaging.
Main Results:
- Simulated SL arthrodesis maintained stable fusion with no significant change in the SL angle.
- Statistically significant reductions in wrist flexion (6-9°) and dart-thrower's motion (5-9°) were observed.
- No other significant differences in ROM were noted compared to baseline.
Conclusions:
- The observed ROM changes after simulated SL arthrodesis are likely of minimal clinical significance.
- SL arthrodesis may be a reconsidered treatment option for SL instability due to favorable functional outcomes.
