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Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative study
Richard Chan1, Justine Goursat2, Mathilde Payen3
1Chirurgie Orthopédique Adulte, CHU Charles Nicolle, Rouen, France; Chirurgie de la main et plastique adulte, CHU Charles Nicolle, Rouen, France.
Journal of Plastic Surgery and Hand Surgery
|May 21, 2024
Summary
Four-corner arthrodesis (FCA) and proximal row carpal resection (PRC) offer comparable wrist strength, mobility, and function for advanced collapse osteoarthritis. Proximal row carpal resection showed a lower revision rate compared to four-corner arthrodesis.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Wrist Osteoarthritis Treatment
Background:
- Post-traumatic Scaphoid Non-Union Advanced Collapse (SNAC) and Scapho-Lunate Advanced Collapse (SLAC) osteoarthritis commonly require surgical intervention.
- Four-corner arthrodesis with scaphoid excision (FCA) and proximal row carpal resection (PRC) are established surgical options for these conditions.
Purpose of the Study:
- To compare the clinical outcomes of FCA and PRC in patients with advanced wrist osteoarthritis.
- To evaluate differences in mobility, strength, function, and patient satisfaction between the two surgical techniques.
Main Methods:
- A retrospective cohort study analyzed patients undergoing FCA or PRC between 2009 and 2019.
- Follow-up assessments included range of motion, grip and pinch strength, functional scores (QuickDash, PRWE), and patient satisfaction.
Main Results:
- No significant differences were observed between FCA and PRC in terms of wrist mobility, strength, or functional scores.
- Patient satisfaction scores were similar for both procedures.
- Re-operation rates were higher in the FCA group (14%) compared to the PRC group (0%).
Conclusions:
- Both FCA and PRC are reliable surgical techniques for managing post-traumatic SNAC/SLAC wrist arthritis stage II.
- While functional outcomes are comparable, PRC may have a lower revision rate than FCA.
