Lunate-capitate arthrodesis for scaphoid nonunion: a comparative study.

Humans Scaphoid Bone / surgery Male Arthrodesis / methods Female Retrospective Studies Adult Middle Aged Lunate Bone / surgery Capitate Bone / surgery Fractures, Ununited / surgery Treatment Outcome Wrist Injuries / surgery Range of Motion, Articular Wrist Joint / surgery Young Adult Follow-Up Studies Hand Strength
Four-corner fusion Lunate-capitate fusion Scaphoid nonunion Wrist arthritis

Journal

BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565

Informations de publication

Date de publication:
20 Aug 2024
Historique:
received: 01 06 2024
accepted: 01 08 2024
medline: 21 8 2024
pubmed: 21 8 2024
entrez: 20 8 2024
Statut: epublish

Résumé

Scaphoid nonunion advanced collapse (SNAC) injuries are frequently associated with irreversible degenerative wrist arthritic changes that necessitate surgical intervention. Midcarpal fusion remains the mainstay of the management of SNAC II and III injuries. A successful four-corner fusion (4CF) relies on a stable lunate-capitate fusion (LCF). There have been reports of management relying solely on LCF. The outcomes of LC- and 4 C-fusions in SNAC injuries were not widely documented. The objective of this research is to provide valuable insights into the effectiveness of both fusion procedures in the management of SNAC II and III wrist injuries, with a focus on reporting associated complications, functional and radiological outcomes. This retrospective study encompassed 65 patients diagnosed with SNAC II and III wrist injuries who underwent limited wrist fusion procedures between 2015 and 2024, with a minimum of 2 years of postoperative follow-up. Exclusion criteria encompassed patients with carpal instability, prior wrist surgical interventions, and scapholunate advanced collapse. Following the fusion procedure performed, patients were stratified into two groups: the LCF group consisting of 31 patients, and the 4CF group comprising 34 patients. Preoperative and intraoperative data were retrieved from the patient's medical records. At their final follow-up appointments, patients underwent comprehensive radiographic and clinical evaluations. Clinical outcomes including hand grip strength, range of motion, the Disabilities of the Arm, Shoulder, and Hand Score, and the Mayo Modified Wrist Score, were compared between groups. Any associated complications were reported. The average healing time was 74.7 ± 15.6 and 72.2 ± 13.2 days for the LCF and 4CF groups, respectively. At the final visit, all patients showed functional improvement relative to their preoperative status, with comparable wrist range of motions observed in both groups. The functional wrist scores were slightly better in the LCF patients (P > 0.05). The average grip strength was significantly greater in the LCF group (P = 0.04), with mean strength values of 86.8% and 82.1% of the contralateral side, for the LCF and 4CF groups, respectively. The LCF is not less efficient than the 4CF in the treatment of SNAC II and III wrist injuries. Through a less time-consuming procedure, LCF can efficiently provide comparable results to 4CF. level IV evidence.

Sections du résumé

BACKGROUND BACKGROUND
Scaphoid nonunion advanced collapse (SNAC) injuries are frequently associated with irreversible degenerative wrist arthritic changes that necessitate surgical intervention. Midcarpal fusion remains the mainstay of the management of SNAC II and III injuries. A successful four-corner fusion (4CF) relies on a stable lunate-capitate fusion (LCF). There have been reports of management relying solely on LCF. The outcomes of LC- and 4 C-fusions in SNAC injuries were not widely documented. The objective of this research is to provide valuable insights into the effectiveness of both fusion procedures in the management of SNAC II and III wrist injuries, with a focus on reporting associated complications, functional and radiological outcomes.
PATIENTS AND METHODS METHODS
This retrospective study encompassed 65 patients diagnosed with SNAC II and III wrist injuries who underwent limited wrist fusion procedures between 2015 and 2024, with a minimum of 2 years of postoperative follow-up. Exclusion criteria encompassed patients with carpal instability, prior wrist surgical interventions, and scapholunate advanced collapse. Following the fusion procedure performed, patients were stratified into two groups: the LCF group consisting of 31 patients, and the 4CF group comprising 34 patients. Preoperative and intraoperative data were retrieved from the patient's medical records. At their final follow-up appointments, patients underwent comprehensive radiographic and clinical evaluations. Clinical outcomes including hand grip strength, range of motion, the Disabilities of the Arm, Shoulder, and Hand Score, and the Mayo Modified Wrist Score, were compared between groups. Any associated complications were reported.
RESULTS RESULTS
The average healing time was 74.7 ± 15.6 and 72.2 ± 13.2 days for the LCF and 4CF groups, respectively. At the final visit, all patients showed functional improvement relative to their preoperative status, with comparable wrist range of motions observed in both groups. The functional wrist scores were slightly better in the LCF patients (P > 0.05). The average grip strength was significantly greater in the LCF group (P = 0.04), with mean strength values of 86.8% and 82.1% of the contralateral side, for the LCF and 4CF groups, respectively.
CONCLUSION CONCLUSIONS
The LCF is not less efficient than the 4CF in the treatment of SNAC II and III wrist injuries. Through a less time-consuming procedure, LCF can efficiently provide comparable results to 4CF.
LEVEL OF EVIDENCE METHODS
level IV evidence.

Identifiants

DOI: 10.1186/s12891-024-07755-w PMID: 39164674
pubmed: 39164674
doi: 10.1186/s12891-024-07755-w
pii: 10.1186/s12891-024-07755-w
doi:

Types de publication

Journal Article Comparative Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

653

Informations de copyright

© 2024. The Author(s).

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Auteurs

Amr Elshahhat (A)

Orthopedic Surgery Department, Mansoura University, Algomhoria Street, Mansoura, 33516, Dakahlia, Egypt. amrelshahat@mans.edu.eg.
ORCID: 0000-0002-9600-7754

Yaser Abed (Y)

Orthopedic Surgery Department, Mansoura University, Algomhoria Street, Mansoura, 33516, Dakahlia, Egypt.

Khaled Nour (K)

Orthopedic Surgery Department, Mansoura University, Algomhoria Street, Mansoura, 33516, Dakahlia, Egypt.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Appareil locomoteur › Squelette › Os du membre supérieur › Os de la main › Os du carpe › Os scaphoïde › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures orthopédiques › Arthrodèse › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Appareil locomoteur › Squelette › Os du membre supérieur › Os de la main › Os du carpe › Os lunatum › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Appareil locomoteur › Squelette › Os du membre supérieur › Os de la main › Os du carpe › Os capitatum › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Plaies et blessures › Fractures osseuses › Fractures non consolidées › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Plaies et blessures › Traumatismes du bras › Traumatismes du poignet › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système locomoteur › Amplitude articulaire › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Appareil locomoteur › Squelette › Articulations › Articulations de la main › Articulation du poignet › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Jeune adulte › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Lunate-capitate arthrodesis for scaphoid...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système locomoteur › Force musculaire › Force de la main › Lunate-capitate arthrodesis for scaphoid...