[Functional outcome after midcarpal arthrodesis in the treatment of advanced carpal collapse (SNAC-/SLAC-wrist)].
OBJECTIVE
The purpose of this retrospective study was the evaluation of the functional outcome of midcarpal arthrodesis, its results in the treatment of SNAC/SLAC stage II and III and patients' satisfaction.


METHODS
49 patients that were treated with a midcarpal arthrodesis were re-examined at a mean follow-up time of 47 months. Range of motion was verified and grip strength was measured with a Jamar-Dynamometer II and a pinch-grip. Pain was evaluated by a visual analogue scale (VAS 0 to 100) for stress and under resting conditions. Patients' daily activities and general quality of life were estimated with the DASH questionnaire. Radiographic evaluation was done by conventional X-ray.


RESULTS
Active range of motion was 56 % and grip strength was 76 % of the non-operated wrist. The DASH score was 29 points. Pain relief was 34 % during resting conditions and 31 % after stress respectively. 45 patients demonstrated bony consolidation in X-ray control. Six patients needed further treatment with a total arthrodesis because of pain or absence of bony consolidation. 77 % of the patients returned to their original occupation and 80 % were satisfied with the final result.


CONCLUSIONS
Our data demonstrate that midcarpal fusion is a reliable procedure for treating the difficult condition of advanced carpal collapse if proper realignment of the carpus is performed.
Dacho
A
A
Klinik für Hand-, Plastische und Rekonstruktive Chirurgie, Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Plastische und Handchirurgie der Universität Heidelberg, Ludwigshafen. dacho@web.de
Grundel
J
J
Harth
A
A
Germann
G
G
Sauerbier
M
M
D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D001174:Arthrodesis; D002348:Carpal Bones / Q000293:injuries* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000503:physiopathology* / Q000601:surgery; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012086:Reoperation; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D014954:Wrist Injuries / Q000503:physiopathology / Q000601:surgery*