Scapho-Trapezio-Trapezoid Arthrodesis.

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 135-140 ◽  
Author(s):  
Andrew Kaines ◽  
Hugh Chissell ◽  
Michael Hayes ◽  
Andrew Saies
Keyword(s):  
Pain Relief ◽  
Postoperative Complications ◽  
Range Of Motion ◽  
Grip Strength ◽  
Common Procedure ◽  
Wrist Arthrodesis ◽  
Scapholunate Instability ◽  
Results Of Surgery ◽  
Stt Arthrodesis ◽  
Kienbock’S Disease

Scapho-trapezio-trapezoid (STT) arthrodesis is a relatively common procedure performed for severe STT arthritis, scapholunate instability and Kienböck's disease. Twenty-eight of 31 patients who had undergone this procedure were reviewed at a mean of 65 months following surgery (range 24 to 97 months). Four patients underwent wrist arthrodesis; two for failed STT fusion; and two for uncontrolled pain related to pre-existing carpal osteoarthritis. Ninety-two percent of patients who had a successful STT arthrodesis achieved good or excellent pain relief and 79% were satisfied with the results of surgery. Pain relief was best in patients with a pre-operative diagnosis of STT arthritis. Wrist range of motion and strength were well preserved. No patients developed isolated arthrosis in the radiocarpal, intercarpal or adjacent joints. STT provides excellent pain relief with an acceptable reduction in grip strength and range of motion. However, the benefits of this procedure must be balanced against the potentially serious postoperative complications and the possibility of arthrosis.

scholarly journals Posterior Interosseous Neurectomy Alternative for Treating Chronic Wrist Pain

2019 ◽  
Vol 08 (03) ◽  
pp. 198-201 ◽  
Author(s):  
Ashraf M. Abdelaziz ◽  
Wael Aldahshan ◽  
Faisal Ahmed Hashem El-Sherief ◽  
Yaser El Sayed Hassan Wahd ◽  
Hany Abdel Gawwad Soliman
Keyword(s):  
Pain Relief ◽  
Range Of Motion ◽  
Grip Strength ◽  
Wrist Joint ◽  
Wrist Pain ◽  
Joint Range Of Motion ◽  
The Difference ◽  
Joint Range ◽  
Wrist Denervation ◽  
Chronic Wrist Pain

Background Wrist denervation is one of the several available options for treating chronic wrist pain; partial wrist denervation performed through a single dorsal incision by resecting the distal posterior interosseous nerve provides good outcomes. Questions/Purposes This study evaluated the results of posterior interosseous neurectomy (PIN) in patients with chronic wrist pain secondary to scaphoid nonunion advanced collapse (SNAC) and scapholunate advanced collapse (SLAC). Methods In total, 30 wrists obtained from 28 patients (25 males, 3 females) were assessed. The dominant hands of 25 (right-handed) patients, nondominant hands of 5, and both hands of 2 were considered. The average age at the time of surgery was 35 (range: 19–50) years, and the average follow-up duration was 18 (range: 12–30) months. Fifteen and 13 patients had wrists with SNAC and SLAC, respectively, and all of those underwent PIN performed through the dorsal approach. The pre- and postoperative range of motion, grip strength, and pain relief percentage were recorded for all the 30 wrists. Results The average postoperative Disabilities of the Arm, Shoulder and Hand score was 30 (range: 20–80), and the difference between the pre- and postoperative scores was statistically significant. Ninety percent of the patients were satisfied with the results of PIN and reported improvement in grip strength and pain relief. Conclusions Thus, PIN may be an effective surgical technique for wrist reconstruction. Clinical Relevance To help patients challenge pain and maintain their wrist joint range of motion.

scholarly journals Clinical outcome of combined scaphocapitate fusion and posterior interosseous neurectomy for stage III Kienbock’s disease

2019 ◽  
Vol 5 (6) ◽  
pp. 1025
Author(s):  
Hossam Elden A. Abodonia ◽  
Mohammed H. Elbadawy ◽  
Ahmed A. Basha
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Positive Impact ◽  
Contralateral Side ◽  
Stage Iii ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Flexion Extension ◽  
The Mean ◽  
Kienbock’S Disease

<p class="abstract"><strong>Background:</strong> Treatment of Kienbock’s disease is still controversial. Several authors have described various surgical treatment options for Kienbock’s disease, all of whom reported successful treatment outcomes. The purpose of this study is to explore the clinical results of posterior interosseous neurectomy and scaphocapitate fusion as a treatment option for stage III Kienbock’s disease.</p><p class="abstract"><strong>Methods:</strong> This study evaluated the range of motion, grip and functional results after treatment of ten wrists of stage III Kienbock’s disease. Four males and six females with average age of 26.3 years, seven dominant and three non-dominant wrists were included. Two patients were smokers while six were housewives, three manual workers and a lawyer. The average follow up period was 14.2 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Four patients revealed excellent, three good and three fair results. The mean modified Mayo score was 81.5. Flexion-extension range was 105.5° representing 74.9% of the contralateral side range. The mean flexion and extension range of operated side was increased, while the flexion increase was nonsignificant. Regarding radial-ulnar deviation, the mean range was 33.5° representing 76.5% of the contralateral side. The mean ulnar and radial deviation was increased, while the radial increase was nonsignificant. The mean grip strength was significantly increased to 90 mmHg representing 93.2% of the contralateral side.</p><p><strong>Conclusions:</strong> Scaphocpitate fusion is a recommended solution for treatment of late stages of Kienbock’s disease with lunate collapse. Longer postoperative time has a positive impact on grip strength and flexion-extension range of motion.</p>

Excessive Radial Shortening in Kienböck’s Disease

1990 ◽  
Vol 15 (1) ◽  
pp. 46-48
Author(s):  
R. NAKAMURA ◽  
E. HORII ◽  
T. IMAEDA
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Wrist Pain ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Ulnar Wrist Pain ◽  
And Function ◽  
Kienbock’S Disease

Two patients with Kienböck’s disease who had been treated by radial shortening developed ulnar wrist pain post-operatively due to excessive radial shortening. In both cases, ulnar shortening was required to improve symptoms and function. Excessive radial shortening can cause ulnar wrist pain and compromise the improvement of grip strength and range of motion of the wrist.

Proximal Row Carpectomy Versus Limited Wrist Arthrodesis for Advanced Kienböck’s Disease

1998 ◽  
Vol 23 (6) ◽  
pp. 741-745 ◽  
Author(s):  
R. NAKAMURA ◽  
E. HORII ◽  
K. WATANABE ◽  
E. NAKAO ◽  
H. KATO ◽  
...  
Keyword(s):  
Grip Strength ◽  
Wrist Pain ◽  
Wrist Flexion ◽  
Proximal Row Carpectomy ◽  
Wrist Arthrodesis ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Flexion Extension ◽  
Kienbock’S Disease

The outcomes in 20 patients with advanced Kienböck's disease treated by proximal row carpectomy (seven patients) or limited wrist arthrodesis (13 patients) were reviewed retrospectivey. Postoperatively, the results were more satisfactory in terms of wrist pain, the range of wrist flexion–extension, and grip strength following limited wrist arthrodesis than after proximal row carpectomy, although the differences were not statistically significant. We recommend scaphotrapeziotrapezoid arthrodesis in selected patients with advanced Kienböck's disease who have a fragmented lunate.

The use of a pyrocarbon capitate resurfacing implant in chronic wrist disorders

2013 ◽  
Vol 39 (6) ◽  
pp. 611-618 ◽  
Author(s):  
A. Marcuzzi ◽  
H. Ozben ◽  
A. Russomando
Keyword(s):  
Surgical Treatment ◽  
Pain Relief ◽  
Grip Strength ◽  
Surgical Procedure ◽  
Good Alternative ◽  
Proximal Row Carpectomy ◽  
Wrist Arthrodesis ◽  
Wrist Function ◽  
Arthritic Changes ◽  
Indication For Surgical Treatment

The present study describes the technique and results of proximal row carpectomy with resection of the head of the capitate and replacement with a pyrocarbon capitate resurfacing implant. The major indication for surgical treatment was arthritic changes on the head of the capitate. Patients were assessed by range of motion, grip strength, pain and functional scoring, and radiographic studies. In most patients, wrist function was improved and pain relief was obtained. This surgical procedure may represent a good alternative to total and partial wrist arthrodesis.

Arthrodesis of the Wrist for Osteoarthritis: Outcome with a Minimum Follow-up of 4 Years

2003 ◽  
Vol 28 (6) ◽  
pp. 575-577 ◽  
Author(s):  
L. DE SMET ◽  
J. TRUYEN
Keyword(s):  
Pain Relief ◽  
Grip Strength ◽  
Contralateral Side ◽  
Dash Score ◽  
Wrist Arthrodesis ◽  
Additional Surgery ◽  
The Mean ◽  
Mean Time ◽  
Manual Activity

The outcome of total wrist arthrodesis was reviewed in 36 patients with osteoarthritis after a minimum follow-up of 4 years. Pain relief was not complete, and although 20 were pain free at rest, only six were pain-free during manual activity. Grip strength was 63% of the contralateral side and the DASH score remained high. Only 21 of the 34 could be re-employed. The mean time off work was 14 months. Complications were numerous and additional surgery was required in 21 patients.

Arthroscopic Synovectomy of the Rheumatoid Wrist

1993 ◽  
Vol 18 (1) ◽  
pp. 92-96 ◽  
Author(s):  
L. ADOLFSSON ◽  
G. NYLANDER
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Relief ◽  
Range Of Motion ◽  
Grip Strength ◽  
Surgical Procedure ◽  
Subjective Experience ◽  
Arthroscopic Synovectomy ◽  
Level Of Activity ◽  
Short Period ◽  
Good Pain Relief

18 wrists in 16 patients with synovitis due to rheumatoid arthritis were treated with arthroscopic synovectomy. The surgical procedure and the results after surgery are described. Range of motion, grip strength, subjective experience of pain and level of activity were registered pre-and post-operatively. The operations were found to give good pain relief, increased grip strength, no post-operative stiffness and a short period of rehabilitation.

scholarly journals Lunatum excision and scaphocapitate arthrodesis in Kienböck’s disease

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901769270 ◽  
Author(s):  
Güzelali Özdemir ◽  
Turgut Akgül ◽  
Özgür Çiçekli ◽  
Barış Yılmaz ◽  
Hasan Atbinici ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Circular Plate ◽  
Wrist Flexion ◽  
Wrist Extension ◽  
Kienböck’S Disease ◽  
Vas Score ◽  
Before And After ◽  
Healthy Side ◽  
Kienbock’S Disease

Purpose: The aim of this study was to compare functional results before and after lunatum excision and scaphocapitate arthrodesis (SCA) using an angular stable circular plate in patients with Lichtman’s stage IIIB Kienböck’s disease. Methods: The study included nine patients (six females and three males) with a mean age of 33.2 ± 11 years (range: 18–54 years). Clinical and radiological assessment before and after surgery included wrist extension and flexion, range of motion and grip strength, visual analogue scale (VAS) score to assess pain, modified Mayo wrist scores, and measurements of the scapholunate (SL) angle and modified carpal height ratio. Results: The mean follow-up period was 17.33 ± 4.69 months (range: 12–24 months), mean operation time was 56.67 ± 12.5 min (range: 45–75 min) and mean hospitalization time was 3.44 ± 1.13 days (range: 2–6 days). Preoperative mean wrist extension was 23.89° ± 4.17°, mean wrist flexion was 32.22° ± 5.07°, mean grip strength compared to the healthy side was 34% (range: 28–37%) and mean VAS score was 7.6 (range: 7–8). Modified Mayo wrist scores were poor in all of the nine patients. Post-operative mean wrist extension was 27.78° ± 4.41°, mean wrist flexion was 40.56° ± 4.64°, mean grip strength compared to the healthy side was 71% (range: 63–81%) and mean VAS score was recorded as 1.4 (range: 1–2). Modified Mayo wrist scores were good in five and moderate in four patients. No patients had non-union or additional surgery. Conclusion: Lunatum excision and SCA using angular stable circular plate fixation provide pain relief with acceptable preservation of the range of motion.

scholarly journals Systematic Review of Total Wrist Arthroplasty and Arthrodesis in Wrist Arthritis

2018 ◽  
Vol 07 (05) ◽  
pp. 424-440 ◽  
Author(s):  
Lorenzo Garagnani ◽  
Sam Gidwani ◽  
Onur Berber
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Quality Data ◽  
Fourth Generation ◽  
Secondary Outcome ◽  
Wrist Arthrodesis ◽  
Wrist Fusion ◽  
End Stage ◽  
Wrist Arthroplasty ◽  
Better Than

Background End-stage wrist arthritis has traditionally been treated with a total wrist fusion. There is a recent trend toward motion preserving surgery in the form of total wrist replacement. Questions Is there a functional benefit to performing a total wrist replacement instead of a total wrist fusion in patients with end-stage wrist arthritis? Is there any difference in secondary outcome measures including pain, grip strength, and range of motion? Does the risk of adverse events and treatment failure differ between the two techniques? Methods A systematic literature search was performed to identify studies reporting either total wrist arthrodesis or arthroplasty for end-stage wrist arthritis. Studies were systematically screened and assessed for risk of bias and quality. Data were extracted and reviewed. Results A total of 43 studies were included in the review: 17 on arthrodesis, 24 on arthroplasty, and 2 matched cohort studies. This represented 669 index arthrodesis operations in 603 patients, and 1,371 index arthroplasty operations in 1,295 patients. A significant improvement in functional outcome was seen with both interventions. Similar improvements were seen in pain scores, and modest improvements were seen in grip strength. Range of motion following arthroplasty improved to a functional level in two studies. Complication rates were higher after arthroplasty (range: 0.2–9.5%) than those after arthrodesis (range: 0.1–6.1%; p = 0.06). Fourth-generation implants (range 0.1–2.9%) performed better than earlier designs (range: 0.2–8.1%; p = 0.002). Implant revision rates ranged from 3.5 to 52.6%. Fourth-generation prostheses survival rates were 78% at 15 years (Universal 2), 86% at 10 years (Motec), 90% at 9 years (Re-Motion), and 95% at 8 years (Maestro). Conclusion The newer fourth-generation wrist implants appear to be performing better than earlier designs. Both wrist arthrodesis and wrist arthroplasty improve function, pain, and grip strength. The risk of complication following wrist replacements is higher than that after total wrist arthrodesis.

Comparative Results of Resection of the Distal Ulna in Rheumatoid Arthritis and Post-Traumatic Conditions

1999 ◽  
Vol 24 (6) ◽  
pp. 667-670 ◽  
Author(s):  
K. E. FRASER ◽  
E. DIAO ◽  
C. A. PEIMER ◽  
F. S. SHERWIN
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Relief ◽  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radioulnar Joint ◽  
Distal Ulna ◽  
Radioulnar Joint ◽  
Post Traumatic ◽  
Comparative Results ◽  
Trauma Group

The purpose of this study was to determine whether the results of resection of the distal ulna differed depending upon the underlying aetiology of the condition. Patients with rheumatoid arthritis were compared with patients with post-traumatic wrist complaints. Fifty resections in 40 patients (eight male, 32 female) were assessed with respect to pain, range of motion, and grip strength. Of the 23 rheumatoid wrists, 86% were pain-free following surgery; however, only 36% of the patients in the trauma group reported pain relief postoperatively. Pain relief in posttraumatic patients was more predictable when distal radioulnar joint arthrosis was identified as the sole cause of wrist pain.

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