Radioscpholunate arthrodesis is done in selected patients who would not accept loss of motion that accompanies wrist arthrodesis. It is based on the observation that most activities of daily living can be accomplished with wrist motion in the range of 10° flexion, 35° extension, 10° radial deviation, and 15° ulnar deviation.
Wrist arthroplasty can provide pain free mobiity but is not a good option in persons with high physical demands.
As the name indicates,it is an arthrodesis of radius, lunate and scaphoid.
Indications of Radioscapholunate Arthrodesis
This arthrodesis is done in patients with radiocarpal joint degeneration which can result from
- Posttraumatic arthritis
- Inflammatory arthritis
- Scapholunate advanced collapse
The procedure involves exposure of the opposing articular surfaces of the scaphoid, lunate, and distal radius by dorsal approach and cancellous bone graft is placed after removal of the articular cartilage. Few surgeons use kwires , screws or plate for fixation.
Postoperative immobilization for approximately 8 weeks is done. A splint is used for an extended period.
Fusion may take up to three months.
- Painful wrist instability
Scaphoid fractures, and postoperative deterioration of the midcarpal joint have been reported.
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