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• W2516420560 abstract "There is no financial information to disclose. To determine the differences in results of patients with a SLAC 2 wrist treated either by four-corner fusion (4CF) or radioscapholunate (RSL) fusion. Institutional ethics approval was obtained for a prospective randomized patient and assessor blinded trial of patients with SLAC 2 wrists treated with either scaphoid excision and 4CF or RSL fusion with excision of distal scaphoid between March 2013 and September 2014. Pre-operative plain radiograph and computed tomography (CT) scans were performed in all patients. Wrist motion, grip strength, Mayo wrist score and PRWE were collected preoperatively and at 6 and 12 months. Decision for entry into the trial was made after visual inspection of the radiolunate and lunocapitate joints to confirm its status, and the procedure was selected from a numbered envelope. The procedures were performed by 2 fellowship trained surgeons. Plain radiograph was performed post-operatively at 6 weeks and CT at 16 weeks. Twelve patients with 13 wrists were treated. One patient had bilateral wrist involvement. There were 7 wrists in the RSL group and 6 wrists in the 4CF group. Mean age was 53.3 years in RSL and 62.3 years in 4CF. In the RSL group, 2 patients underwent further surgery for re-excision of distal scaphoid, 1 for bone graft to radioscaphoid joint and 1 for total wrist fusion at 100 months. A widened SL interval and incongruous distal scapholunate joint on CT scan was noted in all RSL wrists. There were no complications in 4CF. Preoperative mean range of motion, grip strength, Mayo wrist score and PRWE for the RSL group were (F-E) 41-43 degrees, (RD-UD) 14-24.3 degrees, (GS) 25.2 kg, Mayo 45, PRWE 65; in the 4CF group, they were (F-E) 34-44 degrees, (RD-UD) 7-29 degrees, (GS) 26.4 kg, (Mayo) 55, (PRWE) 61. At 12 months, the RSL group had (F-E) 22.1-27.9 degrees, (RD-UD) 5.6-17.1 degrees, (GS) 27.8 kg, Mayo 67, PRWE 49.8 and the 4CF group (F-E) 39-41 degrees, (RD-UD) 13-21 degrees, (GS) 32 kg, Mayo 74.2, PRWE 20.2. •Patients with a SLAC 2 degenerative wrist arthritis treated with RSL fusion to preserve midcarpal motion have a higher re-operation and conversion to total wrist fusion than those treated by 4CF.•In these patients, the range of motion and PRWE is less than those treated by 4CF at 12 months.•RSL in the SLAC 2 wrist is technically challenging and does not give better results than 4CF." @default.
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• W2516420560 date "2016-09-01" @default.
• W2516420560 modified "2023-09-25" @default.
• W2516420560 title "SLAC 2 Wrist: A Randomized Controlled Trial of Four-corner Fusion and Radioscapholunate Fusion" @default.
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• W2516420560 doi "https://doi.org/10.1016/j.jhsa.2016.07.066" @default.
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