Clinical and radiological outcomes following radioscapholunate fusion

Montoya-Faivre, D.; Pomarès, Germain; Calafat, V.; Dap, F.; Dautel, G.

doi:10.1016/j.otsr.2017.07.012

Cited by 17 publications

(32 citation statements)

References 25 publications

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“…6,14,25 In agreement with the literature, our results showed that DSE significantly reduced STT OA. 8,10,[13][14][15]26 We described three cases of STT OA despite DSE and suspected that the procedure was secondary to an incomplete excision.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors reported this finding but not always provided the results on pain or strength. 10,14,15 The global OA rate after RSL fusion ranges from 0 to 100% in the literature, [8][9][10][11][12] but several series did not distinguish the involved joint: STT or midcarpal (e.g., scaphocapitate, lunocapitate, or triquetrohamate). Although the STT joint anatomically belongs to the midcarpal joint, we separated the two localizations of OA because their origins are different.…”

Section: Discussionmentioning

confidence: 99%

“…Ulnar head resection (Darrach's procedure) was performed for distal radioulnar dislocation or OA. All wrists were immobilized with a forearm cast for a mean period of 6.7 weeks (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Surgical Techniquementioning

confidence: 99%

“…5,7 Despite the reports of early favorable clinical outcomes, long-term series after RSL fusions have emphasized limited wrist motion with high complication rates. 8,9 Nonunion rates range from 0 to 29%, whereas midcarpal OA rates from 0 to 100%. [8][9][10][11][12] Given those complications and the restricted motion after RSL fusion, many authors have modified the procedure by adding distal scaphoid excision (DSE, i.e., excision of the distal pole of the scaphoid) to improve motion in flexion and radial deviation while decreasing scaphotrapeziotrapezoidal (STT) OA.…”

mentioning

confidence: 99%

“…[8][9][10][11][12] Given those complications and the restricted motion after RSL fusion, many authors have modified the procedure by adding distal scaphoid excision (DSE, i.e., excision of the distal pole of the scaphoid) to improve motion in flexion and radial deviation while decreasing scaphotrapeziotrapezoidal (STT) OA. 8,10,[13][14][15] Likewise, excision of the triquetrum (ET) has been proposed to improve motion in extension and ulnar deviation while removing the ulnocarpal impaction. 10,13 To date, no study has investigated the prognostic factors for achieving good clinical or radiographic outcomes after RSL fusion.…”

mentioning

confidence: 99%

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Radioscapholunate Fusion for Radiocarpal Osteoarthritis: Prognostic Factors of Clinical and Radiographic Outcomes

Degeorge

Montoya-Faivre²,

Dap³

et al. 2019

Jnl Wrist Surg

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Background Radioscapholunate (RSL) fusion is a surgical option to manage radiocarpal osteoarthritis. Many authors upgrade the procedure by adding distal scaphoid excision with or without excision of the triquetrum. Our objective was to identify the prognostic factors for good clinical and radiographic outcomes of RSL arthrodesis. Purpose Distal scaphoid excision improves both scaphotrapeziotrapezoidal osteoarthritis and radiocarpal fusion, and excision of the triquetrum is not critical to achieving satisfactory outcomes. Methods In this retrospective and bicentric investigation, all wrists were managed with RSL fusion for posttraumatic radiocarpal osteoarthritis. A total of 85 patients were included and evaluated at the revision by clinical (pain, wrist motion, and strength), functional (Disabilities of the Arm, Shoulder, and Hand questionnaire, Patient-Related Wrist Evaluation score, and Modified Mayo Wrist Score), and radiological (scaphotrapeziotrapezoidal, midcarpal osteoarthritis, and radiocarpal nonunion) examinations. We assessed prognostic factors for clinical and radiographic (osteoarthritis and nonunions) outcomes. Results The average follow-up was 9.1 years (1–21.4). Work-related accidents adversely impacted the clinical outcomes, and distal scaphoid excision significantly improved them and decreased scaphotrapeziotrapezoidal osteoarthritis and nonunion. Neither distal scaphoid excision nor excision of the triquetrum influenced midcarpal osteoarthritis. Radiocarpal fusion was significantly promoted by memory staples and bone grafting. Discussion Distal scaphoid excision should be preferred to improve the functional results while decreasing scaphotrapeziotrapezoidal osteoarthritis and radiocarpal nonunion rates. Excision of the triquetrum appears to be an alternative to radioulnar resection–arthroplasty to solve ulnocarpal impaction syndrome. Strict surgical procedure must be observed to promote RSL fusion combining solid bone fixation and the use of bone graft. Level of evidence This is a level IV, case series, retrospective series.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Radioscapholunate Fusion for Radiocarpal Osteoarthritis: Prognostic Factors of Clinical and Radiographic Outcomes

Degeorge

Montoya-Faivre²,

Dap³

et al. 2019

Jnl Wrist Surg

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Wrist Arthritis: Total Versus Limited Fusion Versus Arthroplasty

Thompson

Flannery²

2022

Controversies in Orthopedic Surgery of the Upper Limb

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Salvage procedure after malunited distal radius fractures and management of pain and stiffness

Keuchel-Strobl

Quadlbauer

Jurkowitsch

et al. 2020

Arch Orthop Trauma Surg

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Indications for surgical treatment of distal radius fractures (DRF) remain controversial in the literature, especially in elderly patients. Complication rates after operatively treated DRF are low and well documented. These include malunion, degenerative osteoarthritis in the radiocarpal joint and subsequently pain and impaired hand function. If conservative treatment fails then salvage procedures are necessary. This review summarizes the therapeutic options available to treat degenerative osteoarthritis after malunited distal radius fractures, regardless of the initial operative or conservative treatment.

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Clinical and radiological outcomes following radioscapholunate fusion

Abstract: RSL fusion is a palliative procedure that preserves some of the wrist's mobility. However, it is a difficult procedure that has a significant nonunion rate. Excision of the DPS may contribute to lowering the nonunion rate.

Cited by 17 publications

References 25 publications

Radioscapholunate Fusion for Radiocarpal Osteoarthritis: Prognostic Factors of Clinical and Radiographic Outcomes

Radioscapholunate Fusion for Radiocarpal Osteoarthritis: Prognostic Factors of Clinical and Radiographic Outcomes

Wrist Arthritis: Total Versus Limited Fusion Versus Arthroplasty

Salvage procedure after malunited distal radius fractures and management of pain and stiffness

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