title: [Arthrodesis of 4 bones of the wrist. Study of 12 follow-up cases].
abstract: From November 1988 to December 1990, 15 four-bone fusions (capitalum-lunatum-triquetrum-hamatum) were performed in our department. 3 cases were lost at follow-up, so we here describe 12 cases reviewed for a clinical and radiologic evaluation. Etiologies were as follows: advanced scapholunate dissociation: 5 cases; advanced pseudarthrosis of the scaphoid: 6 cases; ulnar midcarpal instability: 1 case. Follow-up averaged 18.8 months with a range of 6 to 29 months. Pain was significantly lessened: 9 patients had either no pain, pain influenced only by weather, or pain after sustained effort. Results for strength were average. Joint motion was severely restricted, with individual variations among patients. Remaining joint motion was of little use, and some activities of daily living were thus hampered. Pre and postoperative radiologic analysis of the carpus showed that repositioning the proximal row into the distal row of bones was not necessary. In order to obtain a good result, it suffices to stabilize the existing carpal collapse without attempting to restore carpal height. Study of this short series showed the efficacy of this arthrodesis as regards to pain although it significantly decreased the range of motion.
authors.affiliation: Service de Chirurgie Plastique et Reconstructrice de l'Appareil Locomoteur, Hôpital Jeanne d'Arc, CHRU Nancy.
authors.forename: P
authors.initials: P
authors.lastname: Voche
authors.forename: M
authors.initials: M
authors.lastname: Merle
mesh_terms: D000328:Adult; D001174:Arthrodesis; D002348:Carpal Bones; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D059408:Pain Management; D011542:Pseudarthrosis / Q000601:surgery*; D011859:Radiography; D013997:Time Factors; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*
vernacular_title: L'arthrodèse des 4 os du poignet. Analyse de 12 cas revus.