Wrist Arthritis

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7. Serial radiographs over a period of 10 years in the same patient. On the right wrist (upper row) a radiolunate fusion, combined with a synovectomy and a Darrach ulna resection was performed. The carpus was stable over the observation period. The opposite left wrist remained untreated and showed a marked progression of the carpus destruction with ongoing ulnar carpal shift. 550 HERREN & ISHIKAWA wrist fusion is technically without any specific difficulties. In contrast, the preservation of the bone stock in partial fusion facilitates the wrist fusion procedure.

SCAPHOTRAPEZIOTRAPEZOID ARTHRODESIS FOR ARTHRITIS 541 range of motion together with good strength and function can be achieved [18]. Achieving union, however, can be a challenge and requires strict adherence to surgical and postsurgical guidelines. There is a modification for smokers. Also, a surgical procedure that results in any loss of wrist motion is not the ideal solution. It is clear, therefore, why there are endless attempts in the literature and in practice to solve the problem of scapholunate instability in other ways.

13] Ashmead D IV, Watson HK, Damon C, et al. SLAC wrist salvage. J Hand Surg [Am] 1994;19: 741–50. [14] Mack GR, Bosse MJ, Gelberman RH, et al. The natural history of scaphoid nonunion. J Bone Joint Surg [Am] 1984;66:504–9. [15] Leslie IJ, Dickson RA. The fractured carpal scaphoid: natural history and factors influencing outcome. J Bone Joint Surg [Br] 1981;63:225–30. [16] Barr JS, Elliston WA, Musnick H, et al. Fracture of the carpal navicular (scaphoid) bone. J Bone Joint Surg [Am] 1953;35:609.

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