[The posttraumatic carpal collapse--long-term results after midcarpal fusion].
OBJECTIVE
Midcarpal fusion is a reliable treatment for posttraumatic carpal collapse in the short or midlong term. The long-term results remain, however, unclear. The objective of this study was to assess the long-term clinical outcome but also the incidence of an arthrosis of the radiolunate joint or an ulnar translocation after excision of the scaphoid.


METHODS
37 patients after midcarpal fusion were reexamined after an average follow-up of 97 months clinically and radiologically.


RESULTS
The average range of motion from extension to flexion was 62 degrees, the average grip strength changed from 69 % of the opposite side before surgery to 80 % after surgery. Pain in the verbal analogue scale improved from 2.7 preoperatively to 1.7 postoperatively. The Krimmer wrist score was 72, whereas 28 patients (76 %) reached a good or excellent result. The mean DASH score was 24 points. At the X-rays, ten patients (27 %) showed an arthrosis of the radiolunate joint and/or an ulnar translocation. Differences in clinical results between the groups with or without X-ray pathology were not statistically significant. From 107 patients with a midcarpal fusion in the time of interest, seven (6.5 %) had to be converted into wrist arthrodesis because of ongoing pain.


CONCLUSIONS
Also in the long-term the motion-sparing midcarpal fusion offers a functional advantage over wrist arthrodesis.
Kitzinger
H B
HB
Klinik für Handchirurgie, Bad Neustadt/Saale. hugo@kitzinger.de
Löw
S
S
Karle
B
B
Lanz
U
U
Krimmer
H
H
D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D017885:Collateral Ligaments / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012421:Rupture; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*