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Capitolunate Arthrodesis: A Systematic Review
John C Dunn1, Michael M Polmear1, John P Scanaliato1
1Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, TX.
The Journal of Hand Surgery
|December 11, 2019
Summary
Capitolunate arthrodesis (CLA) is a viable surgical option for wrist conditions like scaphoid nonunion advanced collapse, offering pain relief and return to work with acceptable complication rates.
Area of Science:
- Orthopedic surgery
- Hand and wrist surgery
- Musculoskeletal research
Background:
- Scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) are debilitating wrist conditions.
- Surgical interventions aim to restore function and alleviate pain.
- Capitolunate arthrodesis (CLA) is one such procedure, fusing the capitolunate joint.
Purpose of the Study:
- To review the indications, outcomes, and complications of capitolunate arthrodesis (CLA).
- To assess the feasibility and effectiveness of CLA in treating specific wrist pathologies.
Main Methods:
- A systematic literature search was conducted, identifying 33 articles.
- Six articles met inclusion criteria, encompassing 80 patients with a minimum 12-month follow-up (2000-2018).
- Data on union rates and complications were pooled and analyzed.
Main Results:
- The most common indication was scaphoid nonunion advanced collapse (59%).
- 78% of patients reported being pain-free, and 92% returned to work.
- 96% achieved fusion, with an 11% complication rate including nonunion (3.8%) and loose hardware (6.3%).
Conclusions:
- Capitolunate arthrodesis (CLA) is a feasible surgical option for SLAC and SNAC wrists.
- Complication rates for CLA are comparable to those of 4-corner arthrodesis.
- CLA demonstrates positive outcomes in terms of pain relief and return to work.
