Distal scaphoid excision after radioscaphoid arthrodesis

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• 作者：David McCombe ; Damian C. R. Irel ; ; Ian McNab
• 关键词：Wrist ; scaphoid ; arthrodesis
• 刊名：The Journal of Hand Surgery
• 出版年：2001
• 出版时间：September 2001
• 年：2001
• 卷：26
• 期：5
• 页码：877-882
• 全文大小：372 K

文摘

Radioscaphoid and radioscapholunate arthrodeses are effective surgical procedures for the treatment of nonsalvageable and isolated radiocarpal arthritis. These procedures, however, limit wrist motion significantly as the immobile scaphoid bridges the remaining midcarpal joint. A cadaver study of radioscaphoid arthrodesis followed by distal scaphoid excision was undertaken. Range of motion after radioscaphoid K-wire fixation alone demonstrated a 58 % decrease in the preoperative flexion–extension arc to 60°. After distal scaphoid excision (with the radioscaphoid pins still in place) the flexion–extension arc increased to 122° or 86 % of the preoperative range of motion; most of the increase in motion occurred at the midcarpal joint. Distal scaphoid excision releases the midcarpal joint following radioscaphoid fixation and results in a significantly greater wrist motion. If the results of this cadaver study are extrapolated to clinical practice the addition of this step to the previously described procedures of radioscaphoid or radioscapholunate arthrodesis addresses their major limitation, restricted motion. (J Hand Surg 2001;26A:877–882. Copyright © 2001 by the American Society for Surgery of the Hand.)