Ten-Year Minimum Follow-Up of 4-Corner Fusion for SLAC and SNAC Wrist
| Autor: | Wong A, Wollstein R, Ashmead D, Lois Carlson, Traverso P, Watson Hk |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
musculoskeletal diseases
Adult Wrist Joint medicine.medical_specialty Scapholunate advanced collapse Arthrodesis Osteoarthritis 030230 surgery Wrist 03 medical and health sciences Disability Evaluation 0302 clinical medicine Medicine Humans Orthopedics and Sports Medicine Lunate Bone Aged Retrospective Studies Scaphoid Bone Surgery Articles 030222 orthopedics business.industry Middle Aged medicine.disease Surgery body regions medicine.anatomical_structure Patient Satisfaction Salvage surgery business Follow-Up Studies |
| Zdroj: | Hand (New York, N.Y.). 12(6) |
| ISSN: | 1558-9455 |
| Popis: | Background: Scapholunate advanced collapse (SLAC) of the wrist is the most common degenerative condition of the wrist. Four-corner fusion (4CF) is performed as salvage surgery, though there is limited information on its long-term results. We hypothesized that 4CF is a durable surgery with good clinical long-term function. Methods: A retrospective chart review of patients undergoing 4CF as well as an interview and recent radiographs were obtained. Patients with a follow-up period of less than 10 years were excluded. Long-term evaluation included standard wrist radiographs, wrist range of motion, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Radiographs were evaluated and described by the Kellgren-Lawrence classification. Results: Four hundred eighty-nine wrists underwent a 4CF for SLAC wrist from 1982 to 2003. Twelve patients (15 wrists) were available for follow-up. Average age at surgery was 49.1 years (range, 25-67 years). Average follow-up postsurgery was 18 years (11-27). Scapholunate advanced collapse was the etiology in 13 wrists and scaphoid nonunion advanced collapse in 2 wrists. Average extension/flexion arc was 68.6° (0°-96°), and radial/ulnar deviation arc was 32.9° (0°-5°). QuickDASH scores averaged 7.8 (range, 0-32.5), with only 1 score above 16. Seventy-three percent of radiographs showed minimal to moderate joint destruction, and 27% showed severe joint destruction. Conclusions: Scaphoid excision and 4CF remains a reliable procedure for patients with advanced wrist arthritis. Functional results were good at long-term follow-up despite radiographic changes in the radiolunate joint in 73% of patients. Patient satisfaction was high, and functional impairment was low. |
| Databáze: | OpenAIRE |
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