Purpose: The clinical outcomes of scaphotrapeziotrapezoid (STT) arthrodesis were compared to radial shortening osteotomy (RSO) to determine if any of the treatment methods was superior. The impact of RSO and vascularized bone grafts (VBG) on disease progression were measured based on X-rays to evaluate if a difference in Kienböck's disease (KD) progression exists.
Methods: Out of 98 consecutive patients treated between 1991 and 2013, 46 had STT arthrodesis, 21 had RSO, 7 had VBG, and 3 had VBG and RSO. Patients treated with STT arthrodesis were compared to RSO regarding post-operative range of motion (ROM), wrist pain on the Numeric Rating Scale (NRS), grip strength, duration of incapacity for work, the Disabilities of the Arm, Shoulder, and Hand (DASH), and the Modified Mayo Wrist scores (MMWS). Radiographic assessment (Nattrass index, radioscaphoid angle, and Ståhl index) was performed to determine disease progression following RSO or VBG. Baseline patient characteristics were comparable in all treatment groups.
Results: There were no significant differences in post-operative ROM, wrist pain, grip strength, duration of incapacity, DASH score, or MMWS score following STT arthrodesis (n = 27) or RSO (n = 14). The Ståhl index, the Nattrass index, and the radioscaphoid angle suggested disease progression following RSO (n = 14) and/or VBG (n = 6) although the changes were not significant.
Conclusions: The study failed to demonstrate clinically relevant differences between STT arthrodesis compared to RSO. No evidence was found that decompression or revascularization, or the combination of the two, can reverse or halt the course of the disease.
Level Of Evidence: Therapy, level III, retrospective comparative study with prospectively collected data.
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http://dx.doi.org/10.1186/s13018-015-0276-7 | DOI Listing |
Eur J Orthop Surg Traumatol
July 2024
Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Sciences, 61-545, Poznań, Poland.
Background: The main objective of the present study was to present the biomechanical properties of the wrist in patients who underwent scaphotrapeziotrapezoid arthrodesis when compared to a healthy control hand.
Methods: The study group consisted of 29 consecutive patients who underwent a scaphotrapeziotrapezoid wrist arthrodesis at least 1 year before the research onset. Both hands of all patients were examined in 4 main categories.
Orthop Traumatol Surg Res
March 2024
Department of Hand Surgery, Plastic and Reconstructive Surgery, Nancy University Hospital, centre chirurgical Emile-Gallé, 49, rue Hermite, 54000 Nancy, France; Université de Lorraine, Inserm, IADI, 54000 Nancy, France; CIC, Innovation technologique (facultatif), CHRU-Nancy, Inserm, université de Lorraine, 54000 Nancy, France.
Introduction: Scaphotrapeziotrapezoid (STT) arthrodesis and Pyrocardan® implant for painful isolated STT osteoarthritis have shown good results, but no paper has compared their medium-term outcomes.
Hypotheses: Our main hypothesis would be that the Pyrocardan® implant, by preserving the carpal biomechanics, could lead to better wrist mobility. Our secondary hypotheses would be that no other clinical and radiological differences will be found between these two procedures at a mean 5 years follow-up.
JBJS Rev
October 2023
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
» The scaphotrapeziotrapezoid (STT) joint is a common location of degenerative osteoarthritis (OA) in the wrist.» STT OA may occur in isolation or with concomitant thumb carpometacarpal joint (CMCJ) OA or scapholunate advanced collapse (SLAC) and other wrist OA patterns.» Nonoperative management strategies include activity modification, bracing, anti-inflammatory medications, occupational therapy, and injections.
View Article and Find Full Text PDFJ Hand Surg Asian Pac Vol
October 2023
Department of Hand Surgery, Division of Diseases of the Musculoskeletal System, Turku University Hospital, and CoE TYKS ORTO, Turku, Finland.
Arthroscopic scaphotrapeziotrapezoid (STT) fusion (ASTTF) has emerged in the recent decade as an option for traditional open surgery. This retrospective study describes our technique and results of ASTTF. Medical records and radiological data of patient who had undergone ASTTF between 2014 and 2022 in two tertiary hospitals were reviewed.
View Article and Find Full Text PDFZhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
January 2023
Department of Orthopedics, the 920th Hospital of Joint Logistics Support Force of Chinese PLA, Kunming Yunnan, 650032, P. R. China.
Objective: To summarize the research progress of scaphotrapeziotrapezoid osteoarthritis (STT OA) and its etiology and clinical treatment.
Methods: The domestic and foreign literature on STT OA in recent years was reviewed and the research progress was summarized.
Results: STT OA is a common OA, which is highly prevalent in postmenopausal women and diagnosed by wrist X-ray films.
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