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Clinical outcomes of proximal row carpectomy versus four-corner arthrodesis for post-traumatic wrist arthropathy: a systematic review.
J Hand Surg Eur Vol. 2015 Jun; 40(5):450-7.JH

Abstract

We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I-III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11º) versus 43 (SD 11º); wrist flexion, 32 (SD 10º) versus 36 (SD 11º); flexion-extension arc, 62 (SD 14º) versus 75 (SD 10º); radial deviation, 14 (SD 5º) versus 10 (SD 5º); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial deviation and post-operative hand grip strength (as a percentage of the contralateral side) were significantly better after four-corner arthrodesis. Four-corner arthrodesis gave significantly greater post-operative radial deviation and grip strength as a percentage of the opposite side. Wrist flexion, extension, and the flexion-extension arc were better after proximal row carpectomy, which also had a lower overall complication rate.

Authors+Show Affiliations

Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA bryan.m.saltzman@gmail.com.Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

25294736

Citation

Saltzman, B M., et al. "Clinical Outcomes of Proximal Row Carpectomy Versus Four-corner Arthrodesis for Post-traumatic Wrist Arthropathy: a Systematic Review." The Journal of Hand Surgery, European Volume, vol. 40, no. 5, 2015, pp. 450-7.
Saltzman BM, Frank JM, Slikker W, et al. Clinical outcomes of proximal row carpectomy versus four-corner arthrodesis for post-traumatic wrist arthropathy: a systematic review. J Hand Surg Eur Vol. 2015;40(5):450-7.
Saltzman, B. M., Frank, J. M., Slikker, W., Fernandez, J. J., Cohen, M. S., & Wysocki, R. W. (2015). Clinical outcomes of proximal row carpectomy versus four-corner arthrodesis for post-traumatic wrist arthropathy: a systematic review. The Journal of Hand Surgery, European Volume, 40(5), 450-7. https://doi.org/10.1177/1753193414554359
Saltzman BM, et al. Clinical Outcomes of Proximal Row Carpectomy Versus Four-corner Arthrodesis for Post-traumatic Wrist Arthropathy: a Systematic Review. J Hand Surg Eur Vol. 2015;40(5):450-7. PubMed PMID: 25294736.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical outcomes of proximal row carpectomy versus four-corner arthrodesis for post-traumatic wrist arthropathy: a systematic review. AU - Saltzman,B M, AU - Frank,J M, AU - Slikker,W, AU - Fernandez,J J, AU - Cohen,M S, AU - Wysocki,R W, Y1 - 2014/10/07/ PY - 2014/05/06/received PY - 2014/08/13/accepted PY - 2014/10/9/entrez PY - 2014/10/9/pubmed PY - 2016/4/1/medline KW - Four-corner arthrodesis KW - four-corner fusion KW - proximal row carpectomy KW - scaphoid nonunion advanced collapse KW - wrist arthrosis SP - 450 EP - 7 JF - The Journal of hand surgery, European volume JO - J Hand Surg Eur Vol VL - 40 IS - 5 N2 - We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I-III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11º) versus 43 (SD 11º); wrist flexion, 32 (SD 10º) versus 36 (SD 11º); flexion-extension arc, 62 (SD 14º) versus 75 (SD 10º); radial deviation, 14 (SD 5º) versus 10 (SD 5º); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial deviation and post-operative hand grip strength (as a percentage of the contralateral side) were significantly better after four-corner arthrodesis. Four-corner arthrodesis gave significantly greater post-operative radial deviation and grip strength as a percentage of the opposite side. Wrist flexion, extension, and the flexion-extension arc were better after proximal row carpectomy, which also had a lower overall complication rate. SN - 2043-6289 UR - https://www.unboundmedicine.com/medline/citation/25294736/Clinical_outcomes_of_proximal_row_carpectomy_versus_four_corner_arthrodesis_for_post_traumatic_wrist_arthropathy:_a_systematic_review_ L2 - https://journals.sagepub.com/doi/10.1177/1753193414554359?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -