Scaphoidectomy and Lunocapitate Fusion: A Systematic Review

Scaphoidectomy and lunocapitate fusion (LCF) is a motion-preserving salvage procedure for scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC). This systematic review evaluates its clinical outcomes and complication rates. A systematic search of PubMed, MEDLINE, Embase and Google Scholar identified studies on LCF published between 1993 and 2024. Extracted outcomes included range of motion, grip strength, visual analog scale pain score, Disabilities of the Arm, Shoulder. and Hand (DASH) scores and complications such as nonunion and reoperation rates. Pooled data means were calculated for clinical outcomes for comparison. Nineteen studies comprising 329 patients met inclusion criteria. The flexion-extension arc improved from 74° to 77°, and the radio-ulnar deviation arc improved from 34° to 38°. Grip strength increased from 19.3 to 28.9 kg. Visual analog scale pain scores improved from 5.9 to 1.2. Postoperative DASH scores averaged 21. The nonunion rate was 10% with an average time to union of 11 weeks. The reoperation rate was 13.4%, with hardware-related complications being the leading cause for reoperation. Lunocapitate fusion is a viable treatment option for SLAC and SNAC, demonstrating favourable clinical outcomes. However, higher complication and nonunion rates highlight the need for further research to refine surgical techniques and optimize patient selection.