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Resection of the Distal Scaphoid for Scaphotrapeziotrapezoid Osteoarthritis

From the Institut Kaplan and the Hospital Clinic i Provincial, Barcelona, the Hospital General de Catalunya, Sant Cugat del Vallès, Spain, and the Institut Français de Chirurgie de la Main, Paris, France

Correspondence: M. Garcia-Elias MD PhD, Institut Kaplan, Passeig de la Bonanova, 9, 2on 2a, 08022 Barcelona, Spain. E-mail: m.garcia{at}bcn.servicom.es

Twenty-one patients with symptomatic scaphotrapeziotrapezoid osteoarthritis were treated with partial distal scaphoid excision. In 12 wrists the joint defect was filled with either capsular or tendinous tissue, while in nine no fibrous interposition was done. At an average follow-up time of 29 (range, 12–61) months, 13 wrists were painfree, while eight had occasional mild discomfort. Mean wrist flexion-extension was 119°. Grip and pinch strength improved by an average of 26% and 40% respectively compared with their preoperative status. Fifteen patients returned to their original jobs, while six, who were unemployed, felt unrestricted for activities of daily living. Although patient satisfaction was comparable for both types of treatment, the wrists without fibrous interposition showed significantly greater wrist flexion-extension than patients with soft-tissue interposition. Removal of the distal scaphoid resulted in a DISI pattern of carpal malalignment in 12 wrists. At follow-up, none of these wrists showed further joint deterioration due to residual malalignment.

Journal of Hand Surgery (British and European Volume), Vol. 24, No. 4, 448-452 (1999)
DOI: 10.1054/JHSB.1999.0169


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