In the absence of prosthetic arthroplasty offering good results for the treatment of wrist osteoarthritis, we studied the arthrodesis of three carpal bones (lunate - hamate - capitate) completed by triquetrum and scaphoid excision in the presence of Scapholunate Advanced Collapse (SLAC) or Scaphoid Nonunion Advanced Collapse (SNAC) stage II or III. Clinical data on eight patients between the ages of 32 and 61 years at an average of 29 months after surgery was analyzed. Seven patients reached fusion with a carpal height ratio of 0.39. These arc of dorsal-palmar flexion (DPF) attended 54° and the arc of radio-ulnar deviation (RUD) 29° using the optoelectronic stereophotogrammetry system. The mean polar radius (R) was 14.5° and the envelope shape coefficient (K) was 1.66. This operation could be considered as an alternative for the treatment of patients suffering of SNAC or SLAC stage II and III. Type of study/level of evidence : Therapeutic IV.

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Robot-assisted technique can achieve accurate screw placement in four-corner fusion and reduce operative difficulty: a cadaver study.

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November 2024

Department of Hand Surgery, Beijing Jishuitan Hospital, Capital Medical University, No.31, Xin Jie Kou East Street, Xi Cheng District, Beijing, 100035, China.

Background: The purpose of this study is to explore the feasibility and accuracy of a robot-assisted technique in four-corner fusion compared with traditional freehand operation.

Methods: Twenty cadaver specimens were randomly assigned to the robot-assisted group and freehand groups. Three screws were placed percutaneously to fix the capitate-lunate joint, lunate-triquetrum joint, and triquetrum-hamate-capitate joint in each specimen by robot-assisted or freehand technique.

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Article Synopsis
  • Ulnar-sided wrist pain is a complex issue that often poses diagnostic challenges due to various underlying conditions.
  • Midcarpal impaction syndromes, particularly Hamato-lunate and Triquetro-hamate impingement, are rare but notable causes of this type of wrist pain.
  • The article aims to clarify the recognition, diagnosis, and management of these syndromes by reviewing existing literature on the subject.
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Article Synopsis
  • The study investigates the effectiveness of the Ni-Ti shape memory alloy four-corner arthrodesis concentrator (NT-FCAC) for treating scaphoid nonunion advanced collapse (SNAC) with a decade-long follow-up.
  • Twenty-six patients underwent surgery involving scaphoidectomy and arthrodesis, showing significant improvements in grip strength, wrist mobility, and reduced pain levels postoperatively.
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Factors such as age and joint structure affect normal wrist motion. The midcarpal joint participates in flexion/extension, radial-ulnar/deviation (RUD), and since lunate/wrist type-2 is likely more stable than a lunate/wrist type-1, we suggest that midcarpal joint structure will affect wrist motion. Our purpose was to compare wrist motion in Caucasian and Japanese populations and to associate motion with midcarpal joint morphology.

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