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Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis.
J Hand Surg Am. 2015 Nov; 40(11):2176-82.JH

Abstract

PURPOSE

To report the clinical and radiographic results of a consecutive series of patients who underwent the 3-corner arthrodesis (3CA) (arthrodesis of capitate, hamate, and lunate with scaphoid and triquetrum excision) procedure for wrist arthritis.

METHODS

This was a retrospective study of 30 consecutive patients who underwent a 3CA between 1994 and 2008. The indications were painful wrist osteoarthritis due to stage 2 or 3 scapholunate advanced collapse, scaphoid nonunion advanced collapse, or scaphoid chondrocalcinosis advanced collapse wrists. The clinical assessment consisted of range of motion, grip strength, and the Disabilities of the Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores. The radiographic assessment parameters consisted of bone fusion, carpal height and translation, lunate tilt, and appearance of the radiolunate joint space.

RESULTS

The average follow-up was 6 years (± 4 years). The arthrodesis was performed with staples, 2 screws, or a plate and screws. Grip strength was 72% of the contralateral side. The mean range of motion in flexion-extension arc and ulnar-radial deviation arc was 70° and 36°, respectively. The mean Disabilities of the Arm, Shoulder, and Hand and the Patient-Rated Wrist Evaluation scores were 17 (± 11) and 22 (± 24), respectively. The fusion incidence was 90% (27 of 30). The mean difference of radiolunate angle on preoperative and postoperative radiographs was 8° (16°-8° in dorsal direction). The radiolunate joint space had narrowed in 1 patient. Six surgical revisions (20%) were necessary owing to dorsal pain in patients operated using plates, staples, or excessively long screws.

CONCLUSIONS

Three-corner arthrodesis results are comparable with 4-corner arthrodesis and proximal row carpectomy. We feel that it is simpler technically than 4-corner arthrodesis. Although 3CA is more complex than proximal row carpectomy, it preserves the native radiolunate joint. Complications that can be attributed to the dorsal fixation hardware (particularly staples and plates) were noteworthy.

TYPE OF STUDY/LEVEL OF EVIDENCE

Therapeutic IV.

Authors+Show Affiliations

Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France.Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France.Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France.Clinique Lille-Sud, Lesquin, France.Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France. Electronic address: drarthurlasnier@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26409577

Citation

Delattre, Olivier, et al. "Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis." The Journal of Hand Surgery, vol. 40, no. 11, 2015, pp. 2176-82.
Delattre O, Goulon G, Vogels J, et al. Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis. J Hand Surg Am. 2015;40(11):2176-82.
Delattre, O., Goulon, G., Vogels, J., Wavreille, G., & Lasnier, A. (2015). Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis. The Journal of Hand Surgery, 40(11), 2176-82. https://doi.org/10.1016/j.jhsa.2015.07.032
Delattre O, et al. Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis. J Hand Surg Am. 2015;40(11):2176-82. PubMed PMID: 26409577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis. AU - Delattre,Olivier, AU - Goulon,Gilles, AU - Vogels,Jérôme, AU - Wavreille,Guillaume, AU - Lasnier,Arthur, Y1 - 2015/09/26/ PY - 2015/01/13/received PY - 2015/07/30/revised PY - 2015/07/30/accepted PY - 2015/9/28/entrez PY - 2015/9/28/pubmed PY - 2016/9/16/medline KW - Arthritis KW - arthrodesis KW - three-corner fusion KW - triquetrum excision KW - wrist SP - 2176 EP - 82 JF - The Journal of hand surgery JO - J Hand Surg Am VL - 40 IS - 11 N2 - PURPOSE: To report the clinical and radiographic results of a consecutive series of patients who underwent the 3-corner arthrodesis (3CA) (arthrodesis of capitate, hamate, and lunate with scaphoid and triquetrum excision) procedure for wrist arthritis. METHODS: This was a retrospective study of 30 consecutive patients who underwent a 3CA between 1994 and 2008. The indications were painful wrist osteoarthritis due to stage 2 or 3 scapholunate advanced collapse, scaphoid nonunion advanced collapse, or scaphoid chondrocalcinosis advanced collapse wrists. The clinical assessment consisted of range of motion, grip strength, and the Disabilities of the Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores. The radiographic assessment parameters consisted of bone fusion, carpal height and translation, lunate tilt, and appearance of the radiolunate joint space. RESULTS: The average follow-up was 6 years (± 4 years). The arthrodesis was performed with staples, 2 screws, or a plate and screws. Grip strength was 72% of the contralateral side. The mean range of motion in flexion-extension arc and ulnar-radial deviation arc was 70° and 36°, respectively. The mean Disabilities of the Arm, Shoulder, and Hand and the Patient-Rated Wrist Evaluation scores were 17 (± 11) and 22 (± 24), respectively. The fusion incidence was 90% (27 of 30). The mean difference of radiolunate angle on preoperative and postoperative radiographs was 8° (16°-8° in dorsal direction). The radiolunate joint space had narrowed in 1 patient. Six surgical revisions (20%) were necessary owing to dorsal pain in patients operated using plates, staples, or excessively long screws. CONCLUSIONS: Three-corner arthrodesis results are comparable with 4-corner arthrodesis and proximal row carpectomy. We feel that it is simpler technically than 4-corner arthrodesis. Although 3CA is more complex than proximal row carpectomy, it preserves the native radiolunate joint. Complications that can be attributed to the dorsal fixation hardware (particularly staples and plates) were noteworthy. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV. SN - 1531-6564 UR - https://www.unboundmedicine.com/medline/citation/26409577/Three_Corner_Arthrodesis_With_Scaphoid_and_Triquetrum_Excision_for_Wrist_Arthritis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0363-5023(15)01034-5 DB - PRIME DP - Unbound Medicine ER -