Arthroscopic Radiolunate Fusion: Surgical Technique

Radiolunate (RL) fusion is a selective salvage procedure for focal post-traumatic radiolunate arthritis, designed to address an isolated radiolunate lesion while preserving the uninvolved wrist compartments. Compared with radioscapholunate fusion, isolated radiolunate fusion preserves the radioscaphoid articulation and may theoretically favor preservation of the dart-throwing motion. Technical descriptions of RL fusion remain limited, particularly for the arthroscopic approach. This article describes a stepwise arthroscopic technique based on precise identification of the radial scapholunate crest and the triangular fibrocartilage complex, controlled osteochondral preparation of the lunate fossa and proximal lunate, arthroscopic cancellous bone grafting, and percutaneous compression screw fixation. The aim of the procedure is to obtain a focused fusion while minimizing capsular disruption, preserving vascularity and ligamentous attachments, and facilitating postoperative recovery.