Limited Wrist Arthrodesis for the Salvage of SLAC Wrist

Abstract

We report the results of limited wrist arthrodesis, a salvage procedure for SLAC wrist. It involves excision of the scaphoid, radial styloidectomy and fusion of the lunate to the capitate and the triquetrum to the hamate, using cancellous lag screws. Twenty-four wrists in 22 patients were reviewed retrospectively at an average follow-up of 23 months. Seventeen of the 22 patients had no pain or mild pain and had retained a mean arc of motion of 48°. Grip strength was 70% of the other side. Four of the 24 patients developed non-unions, two of which had successful revision to limited wrist arthrodesis. The other two required pan arthrodesis of the wrist. Two other patients with persisting pain in spite of solid fusion were also treated by pan arthrodesis of the wrist. Radial styloidectomy did not result in early failure of this procedure and secondary ulnar translocation of the carpus was not seen.