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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Triquetrum controversies in limited carpal fusions

Meeting Abstract

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  • presenting/speaker Essam Elkaref - Alexandria University, Alexandria, Egypt
  • Walid Metwaly - Alexandria University, Alexandria, Egypt

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1093

doi: 10.3205/19ifssh0376, urn:nbn:de:0183-19ifssh03760

Published: February 6, 2020

© 2020 Elkaref et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.