Comparative study between open and arthroscopic techniques for scaphoid excision and four-corner arthrodesis.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Minimally Invasive Procedures

Background:

• Scaphoid excision and four-corner arthrodesis is a surgical procedure for wrist instability.
• Traditional open surgical techniques carry risks of stiffness and limited motion.

Purpose of the Study:

• To compare the clinical and radiological outcomes of arthroscopic versus open scaphoid excision and four-corner arthrodesis.
• To evaluate the efficacy of arthroscopic approach in preserving wrist range of motion.

Main Methods:

• Retrospective comparison of 27 patients undergoing arthroscopic (14) or open (13) scaphoid excision and four-corner arthrodesis.
• Assessment of bone union, wrist range of motion (flexion-extension arc), pain scores, and clinical outcomes.

Main Results:

• Bone union rates were high in both groups (13/14 arthroscopic, 13/13 open).
• The arthroscopic group demonstrated a significantly greater mean postoperative flexion-extension arc (75°) compared to the open group (51°).
• One patient in the open group experienced severe stiffness (10° arc).

Conclusions:

• Both arthroscopic and open scaphoid excision and four-corner arthrodesis yield comparable bone union and clinical outcomes.
• Arthroscopic scaphoid excision and four-corner arthrodesis is advantageous due to a superior postoperative range of motion.