Biomechanical Effects of Radioscapholunate Fusion With Distal Scaphoidectomy and Triquetrum Excision on Dart-Throwing and Wrist Circumduction Motions

Isolated Osseous Excision in the Adult Carpus: A Narrative Review

Various pathologies of the adult carpus result in clinical scenarios where excision can be considered and even recommended. In the appropriate patient population, isolated carpal excision can alleviate pain and improve mobility. Excisions of the pisiform, trapezium, and trapezoid have abundant literature evidence to support positive long-term functional outcomes. In contrast, isolated excision of the capitate, hamate, and triquetrum has limited support in the literature secondary to compromise of carpal mechanics and lead to recurrent pain. Additionally, isolated scaphoid and lunate excision are best avoided secondary to carpal collapse and should be paired with concomitant stabilizing procedures in the carpus. This article provides a comprehensive literature review of isolated excision of each osseous carpal bone, their indications, and previously assessed outcomes.

Wrist Arthritis and Arthrodesis: Preserving Function, Minimizing Problems

Wrist arthritis is a common condition with numerous causes and presentations. Several management options exist, and treatment should be individualized based on patient age, comorbidities, occupation, duration of symptoms, and failed treatment modalities. Arthroscopy and denervation are appealing because of shorter recovery time and preservation of motion, but duration of effectiveness varies between patients. Patients who fail these smaller procedures or those with pancarpal arthrosis are treated effectively with total wrist arthrodesis or total wrist arthroplasty in lower-demand patients. This article reviews causes and patterns of wrist arthritis and discusses treatment strategies aimed at preserving function and minimizing complications.

Arthroscopic Radioscapholunate Fusion: Surgical Technique

The development of radioscapholunar osteoarthritis after a distal radius joint fracture is a challenge, especially when it is addressed to young patients who want to maintain some wrist mobility. Classically, radioscapholunar arthrodesis is performed by an open longitudinal approach of more than 10 cm on the dorsal surface, largely exposing the midcarpal level. Wrist arthroscopy has already shown its effectiveness in preserving joint mobility compared to open procedures. Performing this arthroscopic procedure minimizes the "aggression" of the joint and hypothetically provides better mobility. This article details the surgical technique for performing radioscapholunar arthrodesis arthroscopically.