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Scaphocapitolunate arthrodesis

M B Rotman1, P R Manske, D L Pruitt

  • 1Division of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Mo 63110.

The Journal of Hand Surgery
|January 1, 1993
PubMed
Summary
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Scaphocapitolunate arthrodesis effectively treats scapholunate ligament tears and scaphoid nonunions, with 81% healing after surgery. Most patients experienced reduced pain and returned to work, demonstrating the procedure's functional benefits.

Area of Science:

  • Orthopedic surgery
  • Hand surgery
  • Wrist reconstruction

Background:

  • Chronic scapholunate ligament incompetence and scaphoid nonunion are debilitating wrist conditions.
  • Scaphocapitolunate arthrodesis is a surgical option for these challenging pathologies.

Purpose of the Study:

  • To evaluate the outcomes of scaphocapitolunate arthrodesis in patients with chronic scapholunate ligament incompetence or scaphoid nonunion.
  • To assess healing rates, functional recovery, pain reduction, and return to work after the procedure.

Main Methods:

  • Retrospective review of 21 patients undergoing scaphocapitolunate arthrodesis since 1985.
  • Dorsal approach with autogenous bone grafting and Kirschner wire fixation.
  • Assessment of radiographic healing, range of motion, grip strength, pain levels, and return to work.

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Main Results:

  • 81% of patients achieved healing after the primary procedure.
  • Significant pain reduction reported in 80% of patients.
  • 16 out of 20 patients returned to work; grip strength averaged 70% of the contralateral side.

Conclusions:

  • Scaphocapitolunate arthrodesis is a viable surgical treatment for chronic scapholunate ligament incompetence and scaphoid nonunion.
  • The procedure demonstrates high healing rates, significant pain relief, and favorable return-to-work outcomes.
  • Potential for mild degenerative changes at the radiocarpal joint should be considered in long-term follow-up.