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Clinical and radiological outcomes of 40 cases of SLAC and SNAC wrist treated by four-corner arthrodesis with locking plate.
Hand Surg Rehabil. 2020 02; 39(1):36-40.HS

Abstract

The treatment of scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist varies. No clear consensus exists on surgical indications. Scaphoid excision and four-corner arthrodesis with locking plate is one of preferred treatments for these lesions. The purpose of this study was to assess the clinical and radiological outcomes of locking plates for treating SNAC and SLAC wrist after a mean follow-up of 5 years and to compare these outcomes with the results reported in the literature. A retrospective study was conducted in two hospitals, involving 40 patients who underwent scaphoid excision and four-corner arthrodesis with locking plate between January 2006 and September 2016. All patients were reviewed as outpatients with clinical and radiographic measurements. At the last follow-up, the mean pain level on visual analog scale (VAS) was 2.5/10 [0-7] (SD: 1.7). Patients had a mean flexion of 46% and a mean extension of 46% compared to the contralateral side. An 18% gain was observed in grip strength. The mean postoperative QuickDASH score was 30 [0-57] (SD: 15.3). Seventy percent of patients were satisfied with the operation. Complete (all four joint interfaces) joint space fusion was achieved in 55% of patients. Only one patient (2.5%) had no joint fusion. The joint between the lunate and the capitate was fused in 38 patients (95%). Nine patients suffered complications; eight of them required surgical revision (20%). Four-corner arthrodesis with locking plate is a valuable surgical technique for treating SLAC and SNAC wrist because it preserve satisfactory range of motion and grip strength (64% compared to the non-operated side), maintains the height of the carpus and prevents the premature appearance of radiocarpal osteoarthritis, as long as the technical challenges of this procedure are mastered.

Authors+Show Affiliations

Chirurgie orthopédique, university hospital Center of Amiens, avenue Rene Laennec, 80480 Salouel, France. Electronic address: judierimokh@gmail.com.Chirurgie orthopédique, university hospital Center of Amiens, avenue Rene Laennec, 80480 Salouel, France.Saint Quentin Hospital Center, 1, avenue Michel de l'Hospital, 02321 Saint-Quentin, France.Chirurgie orthopédique, university hospital Center of Amiens, avenue Rene Laennec, 80480 Salouel, France.Saint Quentin Hospital Center, 1, avenue Michel de l'Hospital, 02321 Saint-Quentin, France.Chirurgie orthopédique, university hospital Center of Amiens, avenue Rene Laennec, 80480 Salouel, France.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

31751792

Citation

Rimokh, J, et al. "Clinical and Radiological Outcomes of 40 Cases of SLAC and SNAC Wrist Treated By Four-corner Arthrodesis With Locking Plate." Hand Surgery & Rehabilitation, vol. 39, no. 1, 2020, pp. 36-40.
Rimokh J, Benazech B, Lebeau N, et al. Clinical and radiological outcomes of 40 cases of SLAC and SNAC wrist treated by four-corner arthrodesis with locking plate. Hand Surg Rehabil. 2020;39(1):36-40.
Rimokh, J., Benazech, B., Lebeau, N., Haddad, B., Moughabghab, M., & David, E. (2020). Clinical and radiological outcomes of 40 cases of SLAC and SNAC wrist treated by four-corner arthrodesis with locking plate. Hand Surgery & Rehabilitation, 39(1), 36-40. https://doi.org/10.1016/j.hansur.2019.10.196
Rimokh J, et al. Clinical and Radiological Outcomes of 40 Cases of SLAC and SNAC Wrist Treated By Four-corner Arthrodesis With Locking Plate. Hand Surg Rehabil. 2020;39(1):36-40. PubMed PMID: 31751792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and radiological outcomes of 40 cases of SLAC and SNAC wrist treated by four-corner arthrodesis with locking plate. AU - Rimokh,J, AU - Benazech,B, AU - Lebeau,N, AU - Haddad,B, AU - Moughabghab,M, AU - David,E, Y1 - 2019/11/18/ PY - 2018/12/06/received PY - 2019/07/15/revised PY - 2019/10/01/accepted PY - 2019/11/22/pubmed PY - 2021/6/9/medline PY - 2019/11/22/entrez KW - Arthrodèse des 4 os KW - Four-corner arthrodesis KW - Locking plate KW - Plaque verrouillée KW - Poignet KW - SLAC lésions KW - SLAC wrist KW - SNAC lésions KW - SNAC wrist KW - Wrist SP - 36 EP - 40 JF - Hand surgery & rehabilitation JO - Hand Surg Rehabil VL - 39 IS - 1 N2 - The treatment of scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrist varies. No clear consensus exists on surgical indications. Scaphoid excision and four-corner arthrodesis with locking plate is one of preferred treatments for these lesions. The purpose of this study was to assess the clinical and radiological outcomes of locking plates for treating SNAC and SLAC wrist after a mean follow-up of 5 years and to compare these outcomes with the results reported in the literature. A retrospective study was conducted in two hospitals, involving 40 patients who underwent scaphoid excision and four-corner arthrodesis with locking plate between January 2006 and September 2016. All patients were reviewed as outpatients with clinical and radiographic measurements. At the last follow-up, the mean pain level on visual analog scale (VAS) was 2.5/10 [0-7] (SD: 1.7). Patients had a mean flexion of 46% and a mean extension of 46% compared to the contralateral side. An 18% gain was observed in grip strength. The mean postoperative QuickDASH score was 30 [0-57] (SD: 15.3). Seventy percent of patients were satisfied with the operation. Complete (all four joint interfaces) joint space fusion was achieved in 55% of patients. Only one patient (2.5%) had no joint fusion. The joint between the lunate and the capitate was fused in 38 patients (95%). Nine patients suffered complications; eight of them required surgical revision (20%). Four-corner arthrodesis with locking plate is a valuable surgical technique for treating SLAC and SNAC wrist because it preserve satisfactory range of motion and grip strength (64% compared to the non-operated side), maintains the height of the carpus and prevents the premature appearance of radiocarpal osteoarthritis, as long as the technical challenges of this procedure are mastered. SN - 2468-1210 UR - https://www.unboundmedicine.com/medline/citation/31751792/Clinical_and_radiological_outcomes_of_40_cases_of_SLAC_and_SNAC_wrist_treated_by_four_corner_arthrodesis_with_locking_plate_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2468-1229(19)30342-1 DB - PRIME DP - Unbound Medicine ER -