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Lunotriquetral arthrodesis. A controversial procedure
G R Sennwald1, M Fischer, P Mondi
1Chirurgie St Leonhard, St Gallen, Switzerland.
Journal of Hand Surgery (Edinburgh, Scotland)
|December 1, 1995
Summary
Lunotriquetral (LT) arthrodesis offers significant pain relief and improved return to work, but high pseudarthrosis rates and unpredictable outcomes suggest alternative fusion techniques may be preferable.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
Background:
- Lunotriquetral (LT) arthrodesis is a surgical procedure to fuse the lunate and triquetrum bones in the wrist.
- Patient outcomes and functional recovery following LT arthrodesis require further investigation.
Purpose of the Study:
- To evaluate the clinical outcomes and radiographic results of patients undergoing lunotriquetral (LT) arthrodesis.
- To identify factors influencing patient return to work and overall satisfaction after LT arthrodesis.
Main Methods:
- A retrospective review of 23 patients (12 male, 11 female) who underwent LT arthrodesis.
- Median follow-up of 28 months, assessing pain relief, Culp wrist scores, return to work, and occupational changes.
- Radiographic analysis included measurement of the LT angle.
Main Results:
- Significant pain relief (P < 0.001) was observed, with a median Culp wrist score of 74.
- A notable difference in work loss between men and women (P = 0.006) was found, correlating with the LT angle (P = 0.007).
- High rates of pseudarthrosis (57%) and a significant number of patients changing occupations (seven men) indicate challenges with this procedure.
Conclusions:
- LT arthrodesis can provide pain relief and improve work status, but outcomes are not fully predictable.
- The high rate of non-union (pseudarthrosis) suggests limitations with current fixation methods, such as two AO lag screws.
- Bone grafting techniques or four-bone fusion for associated conditions may offer more reliable results.