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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2019, Number 3

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Acta Ortop Mex 2019; 33 (3)

Proximal carpectomy versus four-cornered arthrodesis in patients with lesions SLAC and SNAC

Vázquez‑Alonso MF, Díaz‑López JJ, Hernández‑Salcedo E
Full text How to cite this article

Language: Spanish
References: 5
Page: 146-149
PDF size: 125.34 Kb.


Key words:

Carpectomy, 4-corner arthrodesis, pain, wrist, sequel.

ABSTRACT

Advanced scafosemilunar collapse (SLAC) and advanced scaphoid pseudoarthrosis (SNAC) collapse are the result of trauma causing scaphoid fracture and the consequent pseudoarthrosis resulting in abnormal kinematics of the wrist and a scapholunate ligament injury, respectively. Current surgical options for SLAC/SNAC treatment include partial arthrodesis, carpal proximal row resection. Material and methods: Retrospective, cross-cutting and descriptive study was carried out in the period from January 2010 to December 2015. 52 patients operated on with 4-cornered arthrodesis and 19 patients with carpectomy were studied. Results: 71 patients, 62 male patients and 9 female patients were analysed. For the carpectomy procedure were 5 female patients, for patients with four-corner arthrodesis 48 male patient and 4 female patient were included. 48 patients with SNAC and 23 patients with SLAC were identified. 19 carpectomies and 52 arthrodesis of four corners of the total patients 65 of them were carried without any complications, 3 patients with delay of consolidation two with residual pain, and one with superficial infectious process. Discussion: The four-corner arthrodesis technique involves longer surgery and costs in relation to carpectomy, however arthrodesis has a faster return to pain-improvement work with respect to carpectomy; the final decision will depend on the case, the patient’s activity.


REFERENCES

  1. Strauch RJ. Scapholunate advanced collapse and scaphoid nonunion advanced collapse arthritis: evaluation and treatment. J Hand Surg Am. 2011; 36(4): 729-35.

  2. Kitay A, Wolfe SW. Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am. 2012; 37(10): 2175-96.

  3. Wall LB, Didonna ML, Kiefhaber TR, Stern PJ. Proximal row carpectomy: minimum 20-year follow-up. J Hand Surg Am. 2013; 38(8): 1498-504.

  4. Saltzman BM, Frank JM, Slikker W, Fernandez JJ, Cohen MS, Wysocki RW. Clinical outcome of proximal row carpectomy versus four-corner arthrodesis for post-traumatic wrist arthroplasty: a systematic review. J Hand Surg Eur Vol. 2015; 40(5): 450-7.

  5. Skie MC, Gove N, Crocanel DE, Smith H. Management of non-united four-corner fusions. Hand (NY). 2007; 2(1): 34-8.




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Acta Ortop Mex. 2019 May-Jun;33