Abstract
Introduction Radio-scapho-lunate (RSL) arthrodesis has been shown to be an effective treatment for arthritis limited to the radio-carpal joint. It preserves wrist motion at the mid-carpal joint while relieving pain. The main shortcoming of this procedure has been restricted residual wrist range of motion (ROM) compromising clinical outcome. The aim of the study was to assess the effect of excision of distal scaphoid and triquetrum on wrist motion following RSL arthrodesis.
Methods Ten cadaveric wrists had their range of motion measured before and after RSL arthrodesis and after sequential distal scaphoid and then triquetral resection. The mean and standard deviation of the change in motion were calculated for each step. The two-tailed Student’s t-test with p < 0.05 was used to determine the statistical significance of the changes.
Results Distal scaphoid excision after RSL arthrodesis resulted in 25° (35%, p< 0.01) increase in flexion-extension (F-E) arc and 11° (34%, p< 0.01) increase in radio-ulnar (R-U) arc. Subsequent excision of triquetrum further increased F-E arc by 13° (13%, p< 0.05) and R-U arc by 9° (21%, p< 0.01).
Conclusions In the cadaveric wrists, distal scaphoid excision resulted in significantly improved R-U arc and F-E arc. Subsequent triquetral excision further improved wrist ROM. Modification of RSL fusion to include distal scaphoid and triquetrum excision should be considered to improve residual wrist motion.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
None of the authors have received any payment or consideration from any source for the conduct of this study.
