Artikel
Arthroscopy Assisted Partial Wrist Fusion without using Bone Graft
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Autoren
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Abhijeet Wahegaonkar
- Sancheti Institute for Orthopedics & Rehabilitation, Jehangir Hospital, Pune, India
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Satish Mane
- The Hand Surgery Clinics, Sahyadri Hospital, Pune, India
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Chaitanya Karande Patil
- The Hand Surgery Clinics, Sahyadri Hospital, Pune, India
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Anup Bansode
- The Hand Surgery Clinics, Sahyadri Hospital, Pune, India
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: Partial wrist fusion is an effective surgical procedure for providing pain relief while preserving motion of the wrist in patients with localized arthritis of the carpus. The key is to fuse the involved joints and to allow motion through the uninvolved joints. Common indications for partial wrist fusions include scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC).
Wrist arthroscopy allows excellent visualization of the articular surfaces of the carpal bones and ligaments while preserving the vascularity and soft tissue integrity which is violated in procedures employing arthrotomy. This serves as an apt basis for performing arthroscopy assisted partial wrist fusions. All potential complications such as adhesions and loss of movements are minimized by arthroscopic partial wrist fusion combined percutaneous fixation techniques.
Methods: We report our results of arthroscopic partial wrist fusions for various pathologies like Kienbocks disease, scaphoid non-union and post traumatic radio-carpal arthritis. While most authors use bone grafting with these procedures, we report out results withut the use of any bone graft. This reduces the surgical time and morbidity without affecting union rates.
Results and Conclusions: 18 patients underwent arthroscopy assisted partial wrist fusion between June 2013 to December 2016. The pathologies included Kienbocks disease, scaphoid non-union and post traumatic radio-carpal arthritis.
10 patients underwent lunate excision and scapho-capitate fusion for Kienbock's disease, 6 patients with SNAC II/ III wrist following scaphoid non-union underwent a scaphoid excision and capito-lunate fusion, while 2 patients underwent a radio-scapho-lunate fusion following radiocarpal arthritis resulting from a malunited intra-articular fracture of the distal radius. No bone grafting was utilized in any of the cases.
All patients had a significant improvement in their post-operative VAS and Mayo Wrist scores.
No post-surgical complications were observed and uneventful radiologic union was obtained in all cases.
