Arthroscopic-Assisted Partial Wrist Arthrodesis

Partial wrist arthrodesis (PWA) is a well-known procedure for treating degenerative or posttraumatic wrist conditions. Four-corner fusion (4CF) is mostly used for scapholunate advanced collapse and scaphoid nonunion advanced collapse. The author performed 39 procedures, including 4CFs, 2-corner fusions, 3-corner fusions, scaphoid-capitate/scaphoid-capitate-lunate fusions, scaphoid-trapezium-trapezoid arthrodeses, and radioscapholunate arthroscopic PWAs (A-PWAs). There were 8 revision cases including 4 partial nonunions. All A-PWAs healed satisfactorily after revision surgery. This article discusses the surgical techniques and tips to avoid mistakes. The pros and cons for open versus arthroscopic techniques and for screws versus Kirschner wires are also discussed.