Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative study

Background: Four-corner arthrodesis with scaphoid excision (FCA) and proximal row carpal resection (PRC) are frequently performed in wrists with post-traumatic Scaphoid Non- Union Advanced Collapse (SNAC)/Scapho-Lunate Advanced Collapse (SLAC) osteoarthritis. The aim of this study was to compare the...

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Main Authors: Richard Chan, Justine Goursat, Mathilde Payen, Matthieu Lalevée, Kamel Guelmi
Format: Article
Language:English
Published: Medical Journals Sweden 2024-05-01
Series:Journal of Plastic Surgery and Hand Surgery
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Online Access:https://medicaljournalssweden.se/JPHS/article/view/18338
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author Richard Chan
Justine Goursat
Mathilde Payen
Matthieu Lalevée
Kamel Guelmi
author_facet Richard Chan
Justine Goursat
Mathilde Payen
Matthieu Lalevée
Kamel Guelmi
author_sort Richard Chan
collection DOAJ
description Background: Four-corner arthrodesis with scaphoid excision (FCA) and proximal row carpal resection (PRC) are frequently performed in wrists with post-traumatic Scaphoid Non- Union Advanced Collapse (SNAC)/Scapho-Lunate Advanced Collapse (SLAC) osteoarthritis. The aim of this study was to compare the clinical outcomes of these two procedures. Methods: This single-center, retrospective cohort study included all patients who had PRC or FCA between January 1st, 2009 and January 1st, 2019 and who were followed up. Follow-up included: mobility (radial deviation, ulnar deviation, flexion, extension), strength (grip test, pinch test), function (QuickDash, patient-rated wrist evaluation [PRWE]), subjective mobility, and global satisfaction scores. Results: Among 25 patients included, 11 had PRC and 14 had FCA with a mean follow-up of 69.5 months [12–132]. Radial deviation was 18° versus 14° (p = 0.7), ulnar deviation was 21° versus 22° (p = 0.15), flexion was 39° versus 30° (p = 0.32), extension was 32.5° versus 29.5° (p = 0.09), grip test compared to the controlateral side was 72% versus 62% (p = 0.53), Quick Dash score was 12.5 versus 17.6 (p = 0.84), PRWE was 18.7 versus 17.6 (p = 0.38), subjective mobility was 7.8 versus 7.5 (p = 0.23), and satisfaction score was 8.7 versus 9 (p = 0.76), respectively, in the FCA group and the PRC group. Re-operation rates were 14% patients in the FCA group and 0% in the PRC group. Conclusion: This study found no significant difference between FCA and PRC on strength, mobility, and function in patients with post-traumatic SLAC or SNAC stage II wrist arthritis. Both FCA and PRC seem to be reliable surgical techniques with good outcomes with more revision in the FCA group.
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spelling doaj-art-c899b516d07e403f9b6fb4a5307d1e1b2025-08-25T11:16:44ZengMedical Journals SwedenJournal of Plastic Surgery and Hand Surgery2000-67642024-05-015910.2340/jphs.v59.18338Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative studyRichard Chan0Justine Goursat1Mathilde Payen2https://orcid.org/0000-0002-5523-3309Matthieu Lalevée3Kamel Guelmi4Chirurgie Orthopédique Adulte, CHU Charles Nicolle, Rouen, France; Chirurgie de la main et plastique adulte, CHU Charles Nicolle, Rouen, FranceChirurgie Orthopédique Adulte, CHU Charles Nicolle, Rouen, FranceChirurgie Orthopédique Pédiatrique, CHU Charles Nicolle, Rouen, FranceChirurgie Orthopédique Adulte, CHU Charles Nicolle, Rouen, France; CETAPS UR3832, Research Center for Sports and Athletic Activities Transformations, Université de Rouen, Mont-Saint-Aignan, FranceChirurgie Orthopédique Adulte, GHH Monod, Montivilliers, FranceBackground: Four-corner arthrodesis with scaphoid excision (FCA) and proximal row carpal resection (PRC) are frequently performed in wrists with post-traumatic Scaphoid Non- Union Advanced Collapse (SNAC)/Scapho-Lunate Advanced Collapse (SLAC) osteoarthritis. The aim of this study was to compare the clinical outcomes of these two procedures. Methods: This single-center, retrospective cohort study included all patients who had PRC or FCA between January 1st, 2009 and January 1st, 2019 and who were followed up. Follow-up included: mobility (radial deviation, ulnar deviation, flexion, extension), strength (grip test, pinch test), function (QuickDash, patient-rated wrist evaluation [PRWE]), subjective mobility, and global satisfaction scores. Results: Among 25 patients included, 11 had PRC and 14 had FCA with a mean follow-up of 69.5 months [12–132]. Radial deviation was 18° versus 14° (p = 0.7), ulnar deviation was 21° versus 22° (p = 0.15), flexion was 39° versus 30° (p = 0.32), extension was 32.5° versus 29.5° (p = 0.09), grip test compared to the controlateral side was 72% versus 62% (p = 0.53), Quick Dash score was 12.5 versus 17.6 (p = 0.84), PRWE was 18.7 versus 17.6 (p = 0.38), subjective mobility was 7.8 versus 7.5 (p = 0.23), and satisfaction score was 8.7 versus 9 (p = 0.76), respectively, in the FCA group and the PRC group. Re-operation rates were 14% patients in the FCA group and 0% in the PRC group. Conclusion: This study found no significant difference between FCA and PRC on strength, mobility, and function in patients with post-traumatic SLAC or SNAC stage II wrist arthritis. Both FCA and PRC seem to be reliable surgical techniques with good outcomes with more revision in the FCA group. https://medicaljournalssweden.se/JPHS/article/view/18338Hand surgerywristfour bones arthrodesisproximal row carpectomyScaphoid Non Union Advanced CollapseScapho-Lunate Advanced Collapse
spellingShingle Richard Chan
Justine Goursat
Mathilde Payen
Matthieu Lalevée
Kamel Guelmi
Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative study
Journal of Plastic Surgery and Hand Surgery
Hand surgery
wrist
four bones arthrodesis
proximal row carpectomy
Scaphoid Non Union Advanced Collapse
Scapho-Lunate Advanced Collapse
title Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative study
title_full Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative study
title_fullStr Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative study
title_full_unstemmed Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative study
title_short Proximal row carpectomy versus four-corner arthrodesis: a retrospective comparative study
title_sort proximal row carpectomy versus four corner arthrodesis a retrospective comparative study
topic Hand surgery
wrist
four bones arthrodesis
proximal row carpectomy
Scaphoid Non Union Advanced Collapse
Scapho-Lunate Advanced Collapse
url https://medicaljournalssweden.se/JPHS/article/view/18338
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