gms | German Medical Science

Objectives/Interrogation: To describe the technique of the arthroscopic resection of the head of the scaphoid and evaluate the clinical and radiographic results of scapho-trapezium-trapezoid osteoarthritis cases.

Methods: Seventeen cases (13 males and 4 females) with a mean age of 57 years old (24-74 years old) were operated from 2002 to 2015. Inclusion criteria were non-traumatic radial wrist side pain without improvement after 4 months of conservative treatment and positive x-ray images to osteoarthritis. All cases were evaluated preoperatively and postoperatively with pain level, wrist ROM, grip strength and work status (Mayo Wrist Score). DASH and PRWE questionnaries were also given. The technique consisted in the 3-4 mm rounded shape arthroscopic resection of the head of the scaphoid preserving the scapho-trapezial and scapho-capitate ligaments insertion.

Results and Conclusions: At an average follow-up of 24 months all the patients were satisfied. The results showed significant statistical improvement for pain at rest (p=0.001), under maximal load (p=0.0001) and Mayo Wrist Score (p=0.0001). Wrist ROM, grip strength, DASH and PRWE showed an improvement without reaching statistical significance. At x-ray the preoperative mean radio-lunate (RL) angle was 17° (-10° to 35°). The postoperative mean value was 25° (0° to 45°). In the preoperative x-ray evaluation the "critical" RL angle of 15° exceeded in 11 cases. At follow-up, the RL angle increased in 10 cases, unchanged in 7 cases. No one of these cases became symptomatic. Transitory neuroapraxia of the DSBRN was observed in one case. Damage of the DBRA was immediately tied.

The technique of the arthroscopic resection of the distal part of the scaphoid for the STT osteoarthritis demonstrated to be effective and safe with less complications than open surgery.