gms | German Medical Science

Objectives/Interrogation: To demonstrate the pros and cons of triquetrum excision in management of limited degenerative wrist arthritis.

Methods: A prospective single-center study of twenty-two patients (21 male and one female) presented with painful wrist arthritis due to stages 2 or 3 scapholunate advanced collapse or scaphoid non-union advanced collapse wrists. All were treated by three corner fusion (fusion of lunate, capitate and hamate with excision of both scaphoid and triquetrum). Subjective and objective outcome measures were evaluated pre and post-operatively using wrist function scoring system. This study raises the question "should we excise the triquetrum or keep it in place?" The final clinical and radiological outcomes were judged against our previous triquetrum sparing procedures, and also were compared with the studies in the literature concerning lunocapitate fusion with or without excision of triquetrum.

Results and Conclusions: The debatable factors affecting the short and long term results were studied and applied to or cases (with excision or with sparing of the triquetrum). Relative data in the literature also analyzed and compared to our findings. The results were in favor of its excision.

Triquetrum preservation or excision in limited carpal fusions did considerably affect rate of union, time to union as well as the other functional parameters.