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The Role of Arthroscopic Arthrodesis and Minimal Invasive Surgery in the Salvage of the Arthritic Wrist: Midcarpal Joint

  • Joseph F. SladeEmail author
Chapter
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Abstract

Wrist arthritis can be treated with partial wrist fusion to restore function and reduce pain. These procedures require significant surgical dissection and are not without complications. Minimally invasive or percutaneous surgery has been shown to reduce complications and allow for an early return of hand function. We report on partial wrist arthrodesis using minimally invasive surgical techniques including arthroscopy and mini-fluoroscopy. The technique of capitolunate (CL) arthrodesis is described in detail, including results and complications.

Keywords

Distal Radius Scaphoid Fracture Radial Styloid Capsular Release Midcarpal Joint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

I thank Peter C. Yeh, MD for his assistance during the preparation of this manuscript.

References

  1. 1.
    Ashmead D IV, Watson HK, Damon C, Herber S, Paly W. Scapholunate advanced collapse wrist salvage. J Hand Surg. 1994;19(5):741–50CrossRefGoogle Scholar
  2. 2.
    Atik TL, Baratz ME. The role of arthroscopy in wrist arthritis. Hand Clin. 1999;15(3):489–94PubMedGoogle Scholar
  3. 3.
    Calandruccio JH, Gelberman RH, Duncan SFM, Goldfarb CA, Pae R, Gramig W. Capitolunate arthrodesis with scaphoid and triquetrum excision. J Hand Surg. 2000;25A:824–32Google Scholar
  4. 4.
    Calfee RP, Leventhal EL, Wilkerson J, Moore DC, Akelman E, Crisco JJ. Simulated radioscapholunate fusion alters carpal kinematics while preserving dart-thrower’s motion. J Hand Surg. 2008;33(4):503–10CrossRefGoogle Scholar
  5. 5.
    Douglas DP, Peimer CA, Koniuch MP. Motion of the wrist after simulated limited intercarpal arthrodesis: an experimental study. J Bone Joint Surg (Am). 1987;69:1413–8Google Scholar
  6. 6.
    Kleinman WB, Carroll C IV. Scapho-trapezio-trapezoid arthrodesis for treatment of chronic static and dynamic ­scapho-lunate instability: a 10-year perspective on pitfalls and complications. J Hand Surg [Am]. 1990;15(3):408–14CrossRefGoogle Scholar
  7. 7.
    Kobza PE, Budoff JE, Yeh ML, Luo ZP. Management of the scaphoid during four-corner fusion-a cadaveric study. J Hand Surg [Am]. 2003;28(6):904–9CrossRefGoogle Scholar
  8. 8.
    Garcia-Elias M, Lluch A, Ferreres A, Papini-Zorli I, Rahimtoola ZO. Treatment of radiocarpal degenerative osteoarthritis by radioscapholunate arthrodesis and distal scaphoidectomy. J Hand Surg. 2005;30(1):8–15CrossRefGoogle Scholar
  9. 9.
    Guidera PM, Watson HK, Dwyer TA, Orlando G, Zeppieri J, Yasuda M. Lunotriquetral arthrodesis using cancellous bone graft. J Hand Surg [Am]. 2001;26(3):422–7CrossRefGoogle Scholar
  10. 10.
    Hasting DE, Silver RL. Intercarpal arthrodesis in the management of chronic carpal instability after trauma. J Hand Surg [Am]. 1984;9:834–40Google Scholar
  11. 11.
    Ho PC. Arthroscopic partial wrist fusion. Tech Hand Up Extrem Surg. 2008;12(4):242–65CrossRefPubMedGoogle Scholar
  12. 12.
    Kirschenbaum D, Schneider LH, Kirkpatrick WH, Adams DC, Cody RP. Scaphoid excision and capitolunate arthrodesis for radioscaphoid arthritis. J Hand Surg. 1993;18A:780–5Google Scholar
  13. 13.
    Krakauer JD, Bishop AT, Cooney WP. Surgical treatment of scapholunate advanced collapse. J Hand Surg. 1994;19A: 751–9Google Scholar
  14. 14.
    Kleinman WB, Carroll C IV. Scapho-trapezio-trapezoid arthrodesis for treatment of chronic static and dynamic ­scapho-lunate instability: a 10-year perspective on pitfalls and complications. J Hand Surg [Am]. 1990;15(3):408–14CrossRefGoogle Scholar
  15. 15.
    Krimmer H, Wiemer P, Kalb K. Comparative outcome assessment of the wrist joint-mediocarpal partial arthrodesis and total arthrodesis. Handchir Mikrochir Plast Chir. 2000;32(6):369–74CrossRefPubMedGoogle Scholar
  16. 16.
    McCombe D, Ireland DC, McNab I. Distal scaphoid excision after radioscaphoid arthrodesis. J Hand Surg [Am]. 2001;26(5):877–82CrossRefGoogle Scholar
  17. 17.
    Minami A, Kato H, Iwasaki N. Limited wrist fusions: comparison of results 22 and 89 months after surgery. J Hand Surg [Am]. 1999;24:133–7CrossRefGoogle Scholar
  18. 18.
    Moy OJ, Peimer CA. Scaphocapitate fusion in the treatment of Kienböck’s disease. Hand Clin. 1993;9(3):501–4PubMedGoogle Scholar
  19. 19.
    Peterson HA, Lipscomb PR. Intercarpal arthrodesis. Arch Surg. 1967;95:127–34PubMedGoogle Scholar
  20. 20.
    Pisano SM, Peimer CA, Wheeler DR, Sherwin F. Scaphocapitate intercarpal arthrodesis. J Hand Surg. 1991; 16A:328–33Google Scholar
  21. 21.
    Rao SB, Culver JE. Triquetrohamate arthrodesis for midcarpal instability. J Hand Surg [Am]. 1995;20(4):583–9CrossRefGoogle Scholar
  22. 22.
    Rhee SK, Kim HM, Bahk WJ, Kim YW. A comparative study of the surgical procedures to treat advanced Kienböck’s disease. J Korean Med Sci. 1996;11(2):171–8PubMedGoogle Scholar
  23. 23.
    Rotman MB, Manske PR, Pruitt DL, Szerzinski J. Scaphocap­itolunate arthrodesis. J Hand Surg. 1993;18A: 26–33Google Scholar
  24. 24.
    Saffar P. Radio-lunate arthrodesis for distal radial intraarticular malunion. J Hand Surg [Br]. 1996;21(1):14–20Google Scholar
  25. 25.
    Shin EK, Jupiter JB. Radioscapholunate arthrodesis for advanced degenerative radiocarpal osteoarthritis. Tech Hand Up Extrem Surg. 2007;11(3):180–3CrossRefPubMedGoogle Scholar
  26. 26.
    Slade JF III, Bomback DA. Percutaneous capitolunate arthrodesis using arthroscopic or limited approach. Atlas Hand Clin. 2003;8(1):149–162Google Scholar
  27. 27.
    Slade JF, Gillon TJ. Retrospective review of 234 scaphoid fractures and nonunions treated with arthroscopy for union and complications (Special issue – surgery of the hand and upper extremity). Scand J Surg. 2008;97:280–9Google Scholar
  28. 28.
    Slade JF, Gillon TJ. Percutaneous release of the posttraumatic finger joint contracture: a new technique, chapter 11. In: Capo J, Tan V, editors. Atlas of minimally invasive hand and wrist surgery. London: Taylor and Francis; 2007. p. 83–8Google Scholar
  29. 29.
    Slade JF, Dodds SD. Minimally invasive management of scaphoid nonunions. Clin Orthop Relat Res. 2006;445: 108–19.PubMedGoogle Scholar
  30. 30.
    Stanley JK. Radio-lunate arthrodesis. J Hand Surg [Br]. 1989;14(3):283–7Google Scholar
  31. 31.
    Sutro CJ. Treatment of nonunion of the carpal navicular bone. Surgery. 1946;20:536–40PubMedGoogle Scholar
  32. 32.
    Toby EB, Butler TE, McCormack TJ, Jayaraman. A comparison of fication screws for the scaphoid during application of cyclic bending loads. J Bone Joint Surg, 1997;79: 1190–7Google Scholar
  33. 33.
    Vandesande W, De Smet L, Van Ransbeeck H. Lunotriquetral arthrodesis, a procedure with a high failure rate. Acta Orthop Belg. 2001;67(4):361–7PubMedGoogle Scholar
  34. 34.
    Verhellen R, Bain GI. Arthroscopic capsular release for contracture of the wrist: a new technique. Arthroscopy. 2000; 16(1):106–10CrossRefPubMedGoogle Scholar
  35. 35.
    Watson HK, Ballet FL. The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand Surg. 1984;9A:358–65Google Scholar
  36. 36.
    Watson HK, Hempton RF. Limited wrist arthrodeses. I. The triscaphoid joint. Hand Surg [Am]. 1980;5(4):320–7Google Scholar
  37. 37.
    Wheeler DL, McLoughlin SW. Biomechanical assessment of compression screws. Clin Orthop Rel Res. 1998;350: 237–45Google Scholar
  38. 38.
    Zubairy AI, Jones WA. Scapholunate fusion in chronic symptomatic scapholunate instability. J Hand Surg [Br]. 2003;28(4):311–4Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Department of Orthopaedics and RehabilitationYale University School of MedicineNew HavenUSA

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