Atypical Fusions Radioscapholunate/Lunotriquetral: Open vs Arthroscopic

Although radioscapholunate (RSL) and lunotriquetral (LT) fusions are less commonly performed than other limited carpal fusions, they can relieve pain, correct deformity, and restore function for appropriately selected patients with wrist arthritis or instability. Distal scaphoid excision and triquetrum excision may improve range of motion in patients undergoing RSL fusion. Although complete LT coalitions are often asymptomatic, LT fusion may be considered to eliminate motion at the pseudoarthrosis site and relieve pain for symptomatic patients. Arthroscopic approaches may improve visualization and minimize soft tissue disruption but are technically challenging and may be associated with a steep learning curve.