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Lunocapitate versus four-corner fusion in scapholunate or scaphoid nonunion advanced collapse: a randomized

Thorsten Schriever^1,2, Elin Swärd^1,2, Maria Wilcke^1,2

¹Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.

The Journal of Hand Surgery, European Volume

|October 30, 2023

Abstract:

This pragmatic randomized controlled trial compared lunocapitate fusion (LCF) and four-corner fusion (4CF) for scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) in 64 patients. The primary outcome was change in grip strength from preoperative to 1 year postoperatively. The secondary outcomes were Disability of the Hand, Arm, and Shoulder score, Patient Rated Wrist Evaluation score, EuroQol-5D-3L, range of motion, key pinch strength and complications 12 months postoperatively. Grip strength improved only to a small extent and there was no difference between the groups. No differences were found in the secondary outcomes. In conclusion, LCF is not inferior to 4CF regarding strength, range of motion or patient-reported outcome measures.Level of evidence: I.

Keywords:

4CF LCF SLAC SNAC Wrist four-corner fusion lunocapitate fusion osteoarthritis randomized controlled trial

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