gms | German Medical Science

Objectives/Interrogation: The aim of the study was to evaluate short-term results of capitolunate arthrodesis by radial approach and robot-assist screw fixation for the treatment of scaphoid non-union (SNAC) wrists.

Methods: A capitolunate arthrodesis was performed on 6 patients, one woman and 5 men, of 33 years old on average (18-45). All patients were in the 3rd stage of scaphoid non-union degenerative change at time of surgery. The styloidectomy, scaphoidectomy and capitate-lunate arthrodesis was performed by radial approach instead of dorsal approach. Fixations of the arthrodesis with double Acumed cannulated screws were assisted by navigation robot system during insertion stage.

Results and Conclusions: The average follow-up time was 8.7 months (6-12 months). Follow-up evaluation included radiographs, wrist range of motion (flexion-extension, radial-ulnar deviation, and pronation-supination); grip strength; visual analog scale (VAS); and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The average pain on visual analogic scale (VAS) was 1.5. The flexion/extension arc was increased of 15° and strength of 8kg compared to preoperative values on average. All patients returned to their previous working activities. No secondary procedure or complication was observed in all patients.

These results were comparable to or better than the results of previously published techniques in terms of alleviation of pain, grip strength, range of motion and DASH score. The technique has the theoretical advantages of strong compression between capitate and lunate articular cartilage and preserving the dorsal capsular ligament of the wrist joint.