Outcomes of Three Corner Fusion Without Triquetrum Excision Versus Conventional Four Corner Fusion in SNAC Wrist

Ain Shams University

Status: Completed

Conditions: Scaphoid Fracture

Treatments: Procedure: three corner fusion without triquetrum excision; Procedure: Four corner fusion

Study type: Interventional

Funder types: Other

Identifiers

NCT05362240

FMASU M D 296/2019

Details and patient eligibility

About

The investigator compare two types of limited wrist arthrodesis used for management of cases with scaphoid non union advanced collapse (SNAC) as regard the outcome to provide the most suitable technique

Full description

There is a controversy regarding the suitable limited wrist arthrodesis technique for SNAC wrist grade II and III . For several decades , scaphoid excision and four corner fusion (between lunate , capitate , hamate and triquetrum) was the gold standard with good functional outcomes . Later on , a more limited fusion technique was described , three corner fusion ( between lunate , capitate and hamate) with scaphoid and triquetrum excision to improve ulnar deviation range . On the other hand , biomechanical studies mentioned that the triquetrum had a certain proprioceptive function that could be affected when it was included in the fusion process .Furthermore , if the triquetrum was excised the radiolunate contact pressure would increase with higher risk of development of arthritis. The aim of the study to compare the conventional four corner fusion with three corner fusion with triquetrum excision

Enrollment: 34 patients

Sex: All

Ages: 18 to 55 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• SNAC wrist G II , III

Exclusion criteria

• cases with radiolunate arthritis
• Scapholunate advanced collapse
• Grade 1 Scaphoid non union advanced collapse
• Kienbock disease
• Skeletally immature patients

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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34 participants in 2 patient groups

Four corner fusion

Experimental group

Description:

Scaphoid excision and fusion between lunate , capitate , hamate and triquetrum using k.wires

Treatment:

Procedure: Four corner fusion

Three corner fusion without triquetrum excision

Experimental group

Description:

Scaphoid excision with fusion between lunate , capitate and hamate with preservation of triquetrum

Treatment:

Procedure: three corner fusion without triquetrum excision