Acta Ortopédica Mexicana

Arenas ZMV, Marín ED
Functional results of carpal segmental arthrodesis in patients who have carpal navicular pseudoarthrosis or Kienböck’s disease
Acta Ortop Mex 2002; 16 (3)

Language: Español
References: 20
Page: 145-149
PDF: 43.87 Kb.

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ABSTRACT

Objective. Intra-carpal segmental arthrodesis in those patients who have either nechrosis of the lunate bone or carpal navicular non-union, in whom arthrosis of the wrist can be expected, has the objective to avoid the extreme limitation usually produced by complete arthrodesis of the wrist joint. Materials and methods. From January 1997 to December 1999, a series of 15 patients who had navicular pseudoarthrosis in 8 (all male) and Kienböck’s disease in 7 (5 male and 2 female), were treated by partial mid-carpal arthrodesis between the bones navicular-capitate-lunate. All cases had a grade III to IV of arthrosis. Dorsal approach was performed in 14 cases and a double approach in the remaining one. Arthrodesis was reinforced by autologous bone grafting and temporarily fixed by 1.6 mm Kirschner wires and a palmar splint. Results. Bone union of the arthrodesis was achieved in an average of 8.5 weeks, after that, wires were removed. In the cases of the scaphoid, pain disappeared in 4, was mild in 3 and moderate in 1. In the cases of Kienböck’s, 3 were pain free, it was mild in 2 and moderate in 2. No case had severe pain after surgery. Arthrosis improved in all but in one case of Kienböck’s (p=0.05). Range of motion was functional in all (p=0.01); 11 patients (70%) were free of pain as final result. Conclusion. Segmental mid-carpal arthrodesis which is one of the 27 surgical methods that we have found out for treatment of carpal arthrosis, has demonstrated to be an excellent procedure for the functional treatment of chronic damage of the most commonly injured carpal bones such as navicular and lunate.


Key words: carpal navicular, lunate, capitate, pseudoarthrosis, Kienböck, arthrodesis, bone grafting.


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