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Lunate-capitate arthrodesis for scaphoid nonunion: a comparative study
Amr Elshahhat1, Yaser Abed2, Khaled Nour2
1Orthopedic Surgery Department, Mansoura University, Algomhoria Street, Mansoura, 33516, Dakahlia, Egypt. amrelshahat@mans.edu.eg.
BMC Musculoskeletal Disorders
|August 20, 2024
Summary
Lunate-capitate fusion (LCF) offers comparable outcomes to four-corner fusion (4CF) for SNAC II and III wrist injuries. LCF demonstrates slightly better functional scores and significantly greater grip strength, providing an efficient alternative.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Degenerative Joint Disease
Background:
- Scaphoid nonunion advanced collapse (SNAC) injuries lead to degenerative wrist arthritis requiring surgical intervention.
- Midcarpal fusion, particularly four-corner fusion (4CF), is standard for SNAC II and III.
- Limited data exists on the comparative outcomes of lunate-capitate fusion (LCF) versus 4CF.
Purpose of the Study:
- To compare the effectiveness of LCF and 4CF in managing SNAC II and III wrist injuries.
- To evaluate functional outcomes, radiological results, and complications associated with both fusion procedures.
- To provide insights into the efficacy of LCF as a sole procedure.
Main Methods:
- Retrospective study of 65 patients with SNAC II/III wrist injuries undergoing limited wrist fusion (2015-2024).
- Patients divided into LCF (31) and 4CF (34) groups with ≥2 years follow-up.
- Clinical (grip strength, ROM, DASH, MWMS) and radiographic outcomes assessed.
Main Results:
- Average healing times were similar: 74.7 days (LCF) and 72.2 days (4CF).
- Both groups showed functional improvement; wrist range of motion was comparable.
- LCF group had slightly better functional scores (P>0.05) and significantly greater grip strength (86.8% vs 82.1%, P=0.04).
Conclusions:
- LCF is a viable and effective alternative to 4CF for SNAC II and III wrist injuries.
- LCF provides comparable functional and radiological outcomes to 4CF.
- LCF may be a more efficient procedure with comparable results.
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