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Related Experiment Video

Updated: Feb 25, 2026

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[Midcarpal partial arthrodesis with locking plate osteosynthesis].

J-F Hernekamp1, U Kneser2, T Kremer2

  • 1Klinik für Hand‑, Plastische und Rekonstruktive Chirurgie - Schwerbrandverletztenzentrum, BG‑Unfallklinik Ludwigshafen, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Deutschland. Frederick.Hernekamp@pgdiakonie.de.

Operative Orthopadie Und Traumatologie
|August 10, 2017
PubMed
Summary
This summary is machine-generated.

This study demonstrates a surgical technique for advanced carpal collapse, achieving bone consolidation and preserving wrist mobility. Patients experienced significant pain reduction and improved grip strength post-operation.

Keywords:
Limited wrist fusionLocking plateOsteoarthritis of the wristWrist

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Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Musculoskeletal Research

Background:

  • Advanced carpal collapse, including scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC), presents significant challenges in preserving wrist function.
  • Osteoarthritis affecting the radiocarpal and intercarpal joints necessitates effective surgical interventions to manage pain and maintain mobility.

Purpose of the Study:

  • To evaluate a surgical technique aimed at preserving residual wrist mobility and reducing pain in patients with advanced carpal collapse (SLAC/SNAC stages 2-3).
  • To assess the efficacy of scaphoid resection, chondrolysis, and bone grafting with internal fixation in treating severe wrist osteoarthritis.

Main Methods:

  • A dorsal longitudinal incision was utilized, exposing the wrist capsule via a radial capsular flap.
  • Scaphoid resection was performed, followed by chondrolysis of the capitate-lunate and hamate-triquetral articulations.
  • Radial cancellous bone grafting, lunate repositioning, and plate fixation were employed, with postoperative immobilization and physiotherapy.

Main Results:

  • Complete bone consolidation was achieved in all 11 patients within 12 weeks postoperatively, with no implant-related complications.
  • Satisfactory functional outcomes included preserved wrist mobility (53° extension-flexion, 30° radial-ulnar abduction) and grip strength (56% of the contralateral side).
  • Significant pain reduction was reported (VAS 0.7 at rest, 4.3 under load), with a mean Disabilities of the Arm, Shoulder, and Hand (DASH) score of 33.

Conclusions:

  • The described surgical technique effectively addresses advanced carpal collapse by promoting bone consolidation and improving wrist function.
  • This approach offers a viable solution for pain management and preservation of residual mobility in severe wrist osteoarthritis.
  • Further research may explore long-term outcomes and refine surgical protocols for optimal patient results.