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[Preliminary experiences on triscaphoid arthrodesis]

A Marcuzzi1, G Cristiani, L Castagnini

  • 1Cattedra di Chirurgia della Mano, Università degli Studi, Modena.

Minerva Chirurgica
|July 1, 1996
PubMed
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Triscaphoid arthrodesis effectively treats wrist injuries like scaphoid dislocation and Kienboeck's disease, preserving some wrist motion. This procedure yielded excellent results in 80% of patients, with significant pain reduction and improved function.

Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Surgical Techniques

Background:

  • Rotatory dislocation of the scaphoid and Kienboeck's disease (stage 3A) are debilitating wrist conditions.
  • Triscaphoid arthrodesis is a surgical option for these wrist pathologies.
  • Partial wrist arthrodesis aims to preserve some joint mobility.

Observation:

  • A retrospective study evaluated 5 patients (4 males, 1 female) undergoing triscaphoid arthrodesis.
  • The surgical technique involved a dorsal approach, cartilage removal, subchondral bone preparation, and stabilization with Kirschner wires or minicambres.
  • Bone grafting from the distal radial head was utilized to promote fusion.

Findings:

  • Excellent results (80%) were achieved, characterized by pain disappearance, 50% increased joint excursion, and 70% improved hand grip.

Related Experiment Videos

  • Good radiographic consolidation was observed in most cases.
  • One patient (20%) experienced poor outcomes with persistent pain and functional deficit, potentially due to radio-scaphoid angle hypercorrection.

    • Implications:

    • Triscaphoid arthrodesis is a viable treatment for rotatory scaphoid dislocation, triscaphoid arthrosis, and Kienboeck's disease (stage 3A).
    • Maintaining a correct radio-scaphoid angle (approximately 45 degrees) is crucial for surgical success.
    • Limited wrist arthrodesis is preferable to total wrist fusion for preserving hand function.