Midcarpal fusion: clinical and radiological study on outcomes with a minimum follow-up of three years
Article Sidebar
Published:
Nov 19, 2015
Keywords:
Midcarpal fusion, four corner arthrodesis, scaphoid non-union advanced collapse, scapholunate advanced collapse.
Main Article Content
Abstract
ObjectiveFind out the clinical and radiological outcome of patients treated with midcarpal arthrodesis with a minimum follow-up of 3 years.MethodsThe patients treated in our service through midcarpal arthrodesis since May 1998 were studied. From a total of 27 there were included 11 wrists that had a minimum follow-up of 3 years. Eight were men and three women; the mean age was 47 years (16-66) and average follow up 6.7 years (3 to 15). The used technique was 2 or 4 corner fusion with scaphoid resection plus distal radius graft. We evaluated them clinically assessing pain using Visual Analog Scale (VAS), mobility, and grip strength. Underwent QuickDASH and x-rays of control.ResultsPain improved from a preoperative value of 5/10 at rest and 8/10 at activity to 0/10 and 2/10 postoperatively. The mobility the patients lost with respect to the healthy side was 39% flexoextension, 15% of radial deviation, and 31% of ulnar deviation. There were no changes in pronosupination and the postoperative QuickDASH was 10. The force was 92% compared to the contralateral side. Radiologically 4 patients didn´t show changes in radiolunate joint space; in the remaining, it was narrower. Two patients were reoperated for nonunion with bone graft.ConclusionsMidcarpal fusion improves symptoms, retaining 61% of the flexoextension, 85% of the radial deviation, 31% of the ulnar deviation and 92% of the force.
Downloads
Download data is not yet available.
Metrics
Metrics Loading ...
Article Details
How to Cite
De Carli, P., Oñativia, J. I., Donnddorff, A., Alfie, V., Gallucci, G., & Boretto, J. (2015). Midcarpal fusion: clinical and radiological study on outcomes with a minimum follow-up of three years. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 80(4), 274-281. https://doi.org/10.15417/457
Issue
Section
Clinical Research
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
1. Franko OI, Zurakowski D, Day CS. Functional disability of the wrist: direct correlation with decreased wrist motion. J Hand Surg Am 2008;33:485-92. doi:10.1016/j.jhsa.2008.01.005.
2. Luo J, Diao E. Kienböck’s disease: an approach to treatment. Hand Clin 2006;22:465-73; abstract vi. doi:10.1016/j.hcl.2006.07.003.
3. Lauder AJ, Trumble TE. Idiopathic avascular necrosis of the scaphoid: Preiser’s disease. Hand Clin 2006;22:475-84; abstract vi. doi:10.1016/j.hcl.2006.07.005.
4. Arora AS, Chung KC. Otto W. Madelung and the recognition of Madelung’s deformity. J Hand Surg Am 2006;31:177-82. doi:10.1016/j.jhsa.2005.09.001.
5. Watson HK, Hempton RF. Limited wrist arthrodeses. I. The triscaphoid joint. J Hand Surg Am 1980;5:320-7.
6. Watson HK, Ballet FL. The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand Surg Am 1984;9:358-65.
7. Mack GR, Bosse MJ, Gelberman RH, Yu E. The natural history of scaphoid non-union. J Bone Joint Surg Am 1984;66:504-9.
8. Watson HK, Ryu J. Evolution of arthritis of the wrist. Clin Orthop Relat Res 1986;(202):57-67.
9. Weiss KE, Rodner CM. Osteoarthritis of the wrist. J Hand Surg Am 2007;32:725-46. doi:10.1016/j.jhsa.2007.02.003.
10. Watson HK, Goodman ML, Johnson TR. Limited wrist arthrodesis. Part II: Intercarpal and radiocarpal combinations. J Hand Surg Am 1981;6:223-33.
11. Ashmead D, Watson HK, Damon C, Herber S, Paly W. Scapholunate advanced collapse wrist salvage. J Hand Surg Am 1994;19:741-50.
12. Cohen MS, Kozin SH. Degenerative arthritis of the wrist: proximal row carpectomy versus scaphoid excision and four-corner arthrodesis. J Hand Surg Am 2001;26:94-104. doi:10.1053/jhsu.2001.20160.
13. Debottis DP, Werner FW, Sutton LG, Harley BJ. 4-corner arthrodesis and proximal row carpectomy: a biomechanical comparison of wrist motion and tendon forces. J Hand Surg Am 2013;38:893-8. doi:10.1016/j.jhsa.2013.01.033.
14. França Bisneto EN, Freitas MC, Paula EJL De, Mattar Jr R, Zumiotti AV. Comparison between proximal row carpectomy and four-corner fusion for treating osteoarthrosis following carpal trauma: a prospective randomized study. Clinics 2011;66:51-5. doi:10.1590/S1807-59322011000100010.
15. Vanhove W, De Vil J, Van Seymortier P, Boone B, Verdonk R. Proximal row carpectomy versus four-corner arthrodesis as a treatment for SLAC (scapholunate advanced collapse) wrist. J Hand Surg Eur 2008;33:118-25. doi:10.1177/1753193408087116.
16. Enna M, Hoepfner P, Weiss A-PC. Scaphoid excision with four-corner fusion. Hand Clin 2005;21:531-8. doi:10.1016/j.hcl.2005.08.012.
17. Skie M, Grothaus M, Ciocanel D, Goel V. Scaphoid excision with four-corner fusion: a biomechanical study. Hand (N Y) 2007;2:194-8. doi:10.1007/s11552-007-9048-0.
18. Gaston RG, Greenberg J a, Baltera RM, Mih A, Hastings H. Clinical outcomes of scaphoid and triquetral excision with capitolunate arthrodesis versus scaphoid excision and four-corner arthrodesis. J Hand Surg Am 2009;34:1407-12. doi:10.1016/j.jhsa.2009.05.018.
19. Wyrick JD, Stern PJ, Kiefhaber TR. Motion-preserving procedures in the treatment of scapholunate advanced collapse wrist: proximal row carpectomy versus four-corner arthrodesis. J Hand Surg Am 1995;20:965-70. doi:10.1016/S0363-5023(05)80144-3.
20. De Carli P, Donndorf f A, Alfie V, Boretto J, Lopez Ovenza J, Gallucci G. Artrodesis semiluno-grande-piramido-ganchosa: influencia de la posición del semilunar en el rango de movilidad posoperatorio. Rev Asoc Argent Ortop Traumatol 2006:71(2):161-8. http://www.aaot.org.ar/revista/2006/n2_vol71/art11.pdf (Consulta: 11 de febrero, 2015).
21. Rosales RS, Delgado EB, de la Lastra-Bosch ID. Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: Cross-cultural adaptation process and reliability. J Hand Surg Am 2002;27:334-43. doi:10.1053/jhsu.2002.30059.
22. Teresa Hervás M, Navarro Collado MJ, Peiró S, Rodrigo Pérez JL, López Matéu P, Martínez Tello I. Versión española del cuestionario DASH. Adaptación transcultural, fiabilidad, validez y sensibilidad a los cambios. Med Clin (Barc) 2006;127:441-7. doi:10.1157/13093053.
23. Wall LB, Didonna ML, Kiefhaber TR, Stern PJ. Proximal row carpectomy: minimum 20-year follow-up. J Hand Surg Am 2013;38:1498-504. doi:10.1016/j.jhsa.2013.04.028.
24. Chim H, Moran SL. Long-term outcomes of proximal row carpectomy: a systematic review of the literature. J Wrist Surg 2012;1:141-8. doi:10.1055/s-0032-1329547.
25. Gellman H, Kauffman D, Lenihan M, Botte MJ, Sarmiento A. An in vitro analysis of wrist motion: the effect of limited intercarpal arthrodesis and the contributions of the radiocarpal and midcarpal joints. J Hand Surg Am 1988;13:378-83.
26. Kobayashi M, Berger RA, Linscheid RL, An KN. Intercarpal kinematics during wrist motion. Hand Clin 1997;13:143-9.
27. Siegel JM, Ruby LK. A critical look at intercarpal arthrodesis: review of the literature. J Hand Surg Am 1996;21:717-23. doi:10.1016/S0363-5023(96)80037-2.
28. Sauerbier M, Tränkle M, Linsner G, Bickert B, Germann G. Midcarpal arthrodesis with complete scaphoid excision and interposition bone graft in the treatment of advanced carpal collapse (SNAC/SLAC wrist): operative technique and outcome assessment. J Hand Surg Br 2000;25:341-5. doi:10.1054/jhsb.2000.0434.
29. Bain GI, Watts AC. The outcome of scaphoid excision and four-corner arthrodesis for advanced carpal collapse at a minimum of ten years. J Hand Surg Am 2010;35:719-25. doi:10.1016/j.jhsa.2010.01.025.
30. Neubrech F, Mühldorfer-Fodor M, Pillukat T, Schoonhoven J Van, Prommersberger KJ. Long-term results after midcarpal arthrodesis. J Wrist Surg 2012;1:123-8. doi:10.1055/s-0032-1329616.
31. Mulford JS, Ceulemans LJ, Nam D, Axelrod TS. Proximal row carpectomy vs four corner fusion for scapholunate (Slac) or scaphoid nonunion advanced collapse (Snac) wrists: a systematic review of outcomes. J Hand Surg Eur 2009;34:256-63. doi:10.1177/1753193408100954.
2. Luo J, Diao E. Kienböck’s disease: an approach to treatment. Hand Clin 2006;22:465-73; abstract vi. doi:10.1016/j.hcl.2006.07.003.
3. Lauder AJ, Trumble TE. Idiopathic avascular necrosis of the scaphoid: Preiser’s disease. Hand Clin 2006;22:475-84; abstract vi. doi:10.1016/j.hcl.2006.07.005.
4. Arora AS, Chung KC. Otto W. Madelung and the recognition of Madelung’s deformity. J Hand Surg Am 2006;31:177-82. doi:10.1016/j.jhsa.2005.09.001.
5. Watson HK, Hempton RF. Limited wrist arthrodeses. I. The triscaphoid joint. J Hand Surg Am 1980;5:320-7.
6. Watson HK, Ballet FL. The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand Surg Am 1984;9:358-65.
7. Mack GR, Bosse MJ, Gelberman RH, Yu E. The natural history of scaphoid non-union. J Bone Joint Surg Am 1984;66:504-9.
8. Watson HK, Ryu J. Evolution of arthritis of the wrist. Clin Orthop Relat Res 1986;(202):57-67.
9. Weiss KE, Rodner CM. Osteoarthritis of the wrist. J Hand Surg Am 2007;32:725-46. doi:10.1016/j.jhsa.2007.02.003.
10. Watson HK, Goodman ML, Johnson TR. Limited wrist arthrodesis. Part II: Intercarpal and radiocarpal combinations. J Hand Surg Am 1981;6:223-33.
11. Ashmead D, Watson HK, Damon C, Herber S, Paly W. Scapholunate advanced collapse wrist salvage. J Hand Surg Am 1994;19:741-50.
12. Cohen MS, Kozin SH. Degenerative arthritis of the wrist: proximal row carpectomy versus scaphoid excision and four-corner arthrodesis. J Hand Surg Am 2001;26:94-104. doi:10.1053/jhsu.2001.20160.
13. Debottis DP, Werner FW, Sutton LG, Harley BJ. 4-corner arthrodesis and proximal row carpectomy: a biomechanical comparison of wrist motion and tendon forces. J Hand Surg Am 2013;38:893-8. doi:10.1016/j.jhsa.2013.01.033.
14. França Bisneto EN, Freitas MC, Paula EJL De, Mattar Jr R, Zumiotti AV. Comparison between proximal row carpectomy and four-corner fusion for treating osteoarthrosis following carpal trauma: a prospective randomized study. Clinics 2011;66:51-5. doi:10.1590/S1807-59322011000100010.
15. Vanhove W, De Vil J, Van Seymortier P, Boone B, Verdonk R. Proximal row carpectomy versus four-corner arthrodesis as a treatment for SLAC (scapholunate advanced collapse) wrist. J Hand Surg Eur 2008;33:118-25. doi:10.1177/1753193408087116.
16. Enna M, Hoepfner P, Weiss A-PC. Scaphoid excision with four-corner fusion. Hand Clin 2005;21:531-8. doi:10.1016/j.hcl.2005.08.012.
17. Skie M, Grothaus M, Ciocanel D, Goel V. Scaphoid excision with four-corner fusion: a biomechanical study. Hand (N Y) 2007;2:194-8. doi:10.1007/s11552-007-9048-0.
18. Gaston RG, Greenberg J a, Baltera RM, Mih A, Hastings H. Clinical outcomes of scaphoid and triquetral excision with capitolunate arthrodesis versus scaphoid excision and four-corner arthrodesis. J Hand Surg Am 2009;34:1407-12. doi:10.1016/j.jhsa.2009.05.018.
19. Wyrick JD, Stern PJ, Kiefhaber TR. Motion-preserving procedures in the treatment of scapholunate advanced collapse wrist: proximal row carpectomy versus four-corner arthrodesis. J Hand Surg Am 1995;20:965-70. doi:10.1016/S0363-5023(05)80144-3.
20. De Carli P, Donndorf f A, Alfie V, Boretto J, Lopez Ovenza J, Gallucci G. Artrodesis semiluno-grande-piramido-ganchosa: influencia de la posición del semilunar en el rango de movilidad posoperatorio. Rev Asoc Argent Ortop Traumatol 2006:71(2):161-8. http://www.aaot.org.ar/revista/2006/n2_vol71/art11.pdf (Consulta: 11 de febrero, 2015).
21. Rosales RS, Delgado EB, de la Lastra-Bosch ID. Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: Cross-cultural adaptation process and reliability. J Hand Surg Am 2002;27:334-43. doi:10.1053/jhsu.2002.30059.
22. Teresa Hervás M, Navarro Collado MJ, Peiró S, Rodrigo Pérez JL, López Matéu P, Martínez Tello I. Versión española del cuestionario DASH. Adaptación transcultural, fiabilidad, validez y sensibilidad a los cambios. Med Clin (Barc) 2006;127:441-7. doi:10.1157/13093053.
23. Wall LB, Didonna ML, Kiefhaber TR, Stern PJ. Proximal row carpectomy: minimum 20-year follow-up. J Hand Surg Am 2013;38:1498-504. doi:10.1016/j.jhsa.2013.04.028.
24. Chim H, Moran SL. Long-term outcomes of proximal row carpectomy: a systematic review of the literature. J Wrist Surg 2012;1:141-8. doi:10.1055/s-0032-1329547.
25. Gellman H, Kauffman D, Lenihan M, Botte MJ, Sarmiento A. An in vitro analysis of wrist motion: the effect of limited intercarpal arthrodesis and the contributions of the radiocarpal and midcarpal joints. J Hand Surg Am 1988;13:378-83.
26. Kobayashi M, Berger RA, Linscheid RL, An KN. Intercarpal kinematics during wrist motion. Hand Clin 1997;13:143-9.
27. Siegel JM, Ruby LK. A critical look at intercarpal arthrodesis: review of the literature. J Hand Surg Am 1996;21:717-23. doi:10.1016/S0363-5023(96)80037-2.
28. Sauerbier M, Tränkle M, Linsner G, Bickert B, Germann G. Midcarpal arthrodesis with complete scaphoid excision and interposition bone graft in the treatment of advanced carpal collapse (SNAC/SLAC wrist): operative technique and outcome assessment. J Hand Surg Br 2000;25:341-5. doi:10.1054/jhsb.2000.0434.
29. Bain GI, Watts AC. The outcome of scaphoid excision and four-corner arthrodesis for advanced carpal collapse at a minimum of ten years. J Hand Surg Am 2010;35:719-25. doi:10.1016/j.jhsa.2010.01.025.
30. Neubrech F, Mühldorfer-Fodor M, Pillukat T, Schoonhoven J Van, Prommersberger KJ. Long-term results after midcarpal arthrodesis. J Wrist Surg 2012;1:123-8. doi:10.1055/s-0032-1329616.
31. Mulford JS, Ceulemans LJ, Nam D, Axelrod TS. Proximal row carpectomy vs four corner fusion for scapholunate (Slac) or scaphoid nonunion advanced collapse (Snac) wrists: a systematic review of outcomes. J Hand Surg Eur 2009;34:256-63. doi:10.1177/1753193408100954.