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Original Article



Radioscapholunate arthrodesis with distal excision of the distal scaphoid pole: Intraoperative measurement of range of motion and bone graft coming from a radial cortical flap

Cindy Bouvet, Marie Loret, Jean-Yves Beaulieu.




Abstract

Objectives: In a series of 9 cases with radio-carpal arthritis from trauma that benefitted from a radioscapholunate arthrodesis with excision of the distal scaphoid pole, we desired to measure the perioperative range of motion to see if mobility was preserved after the operation. We also sought to describe our graft technique with a bone cover coming from the cortical distal radius.
Methods: We retrospectively collected data from nine patients that benefitted from this surgical technique and we documented the clinical and radiological information.
Results: With a mean follow-up of three years, we had the following perioperative results: flexion 44°, extension 41°, ulnar deviation 24° and radial deviation 17°. This range of motion was depressed at postoperative follow-up. We did not observe any pseudoarthrosis. We did find a high complication rate with three cases of mediocarpal arthritis, one tendon rupture and one radiotriquetral conflict. During the postoperative period, the pain was 0/10.
Conclusions: Radioscapholunate arthrodesis in the case of radiocarpal arthritis with the use of a bone graft coming from the distal radius demonstrated robust results in terms of pain. The perioperative benefit on mobility was not found during postoperative period. A bone graft using a cortical cover from the distal radius yielded favorable results with regards to bone healing.

Key words: Radioscapholunate arthrodesis, scaphoid resection, perioperative range of motion






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