gms | German Medical Science

Objectives/Interrogation: evaluate the functional outcome of patients with advanced lesions and collapse scapholunate advanced collapse scaphoid nonunion treated with proximal row carpectomy versus four corners arthrodesis.

Methods: A retrospective, cross-sectional descriptive study, which will be held in the city of Naucalpan, State of Mexico, in the Medical Unit of High Specialty (UMAE), Hospital of Traumatology and Orthopedics Lomas Verdes is made, the study population were rightholders patients Mexican Social Security Institute, 19 rightholders patients, not probabilistic consecutive cases operated on of carpectomy row proximal versus 52 patients after arthrodesis of 4 corners, consecutive cases nonprobability in the period from 2010 to 2015.

Results: 71 patients, 62 male patients (87.3%) and 9 female patients (12.7%) were analyzed. For Carpectomy were 14 male patients (73.7%) and 5 female patients (26.3%), for patients with four corners arthrodesis were 48 male patients (92.3%) and 4 female patients (7.7%) were included. SNAC 48 patients (67.6%) and 23 patients with SLAC (32.4%) were identified. Proximal row carpectomy 19 (26.8%) and 52 four-corner arthrodesis (73.2%) were performed. Of the total patients, 65 of them (91.5%) were enrolled without any complications, 3 patients with delayed consolidation (4.2%), with residual pain two patients (2.8%) and 1 patient with infectious process (1.4%) were identified. Reintegration time was an average of 5.83 months. The Wilcoxon rank test was performed wherein the variable postoperative pain and preoperative pain have significant value of p <.001. The same test was performed for the Quick Dash prior to the surgical procedure and Quick Dash after the surgical procedure with significant value of p <.001. U test of Mann-Whitney rank was performed for the two groups with a p <.411 for preoperative pain, postoperative pain ap of .037.

Conclusions: The technique of four corners arthrodesis means more surgery time and costs that proximal row carpectomy, but the reincorporation of the patient is faster and satisfaction with the results is slightly higher, plus practically not observed a frequency of complications. Pain before the procedure and after the same was observed with a similar relief four corners arthrodesis and proximal row carpectomy, so the final decision to opt for some is directly related to the patient's occupation and physical demands over other factors.