title: Lunotriquetral arthrodesis.
abstract: Lunotriquetral arthrodesis has been recommended for the treatment of disabling pain at the lunotriquetral joint after more conservative measures have failed. We retrospectively analyzed a series of 22 patients treated with a lunotriquetral arthrodesis for presence of fusion, method of fixation, duration of immobilization, carpal alignment, pain relief, and ability to return to work. Fixation with a Herbert screw supplemented with a Kirschner wire (K-wire) was superior to fixation with K-wires alone. Immobilization longer than 6 weeks was superior to immobilization less than 6 weeks. Combined use of a Herbert screw supplemented with a K-wire and immobilization longer than 6 weeks resulted in union in all patients, even when performed for nonunion after a prior attempted arthrodesis. Pain was improved in all patients; all patients who previously were working returned to work. Routine posteroanterior and lateral x-ray films often failed to adequately profile the arthrodesis site. We recommend using a Herbert screw supplemented with a K-wire for lunotriquetral arthrodesis and keeping the patient in a cast until fusion is documented, usually at least 8 weeks. Fluoroscopic spot views or tomograms are recommended to demonstrate bone fusion.
authors.affiliation: Department of Orthopaedics, University of California, San Francisco 94143-0728.
authors.forename: D L
authors.initials: DL
authors.lastname: Nelson
authors.forename: P R
authors.initials: PR
authors.lastname: Manske
authors.forename: D L
authors.initials: DL
authors.lastname: Pruitt
authors.forename: L A
authors.initials: LA
authors.lastname: Gilula
authors.forename: R A
authors.initials: RA
authors.lastname: Martin
mesh_terms: D000328:Adult; D001174:Arthrodesis / Q000379:methods; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014954:Wrist Injuries / Q000601:surgery