title: Scaphocapitate arthrodesis for treatment of scapholunate instability in manual workers.
abstract: OBJECTIVE
  To assess the long-term efficacy of scaphocapitate arthrodesis for treatment of chronic scapholunate instability in high-demand patients.
  
  
  METHODS
  We retrospectively analyzed the clinical and radiographic results of 20 manual workers who underwent scaphocapitate arthrodesis for chronic scapholunate instability at a mean follow-up of 10 years (range, 1-23 y). We measured range of motion and grip strength; pain on a scale of 0 to 5; Quick Disabilities of the Arm, Shoulder, and Hand score; and ability to return to work. We assessed radiographs for union, carpal height and alignment, signs of ulnar translation or radiocarpal arthritis, and hardware problems.
  
  
  RESULTS
  At most recent follow-up, the arc of motion averaged 87° for flexion-extension and 41° for the radioulnar deviation. The postoperative average maximum grip strength was 21 kg, which was 60% of the opposite, normal wrist. Pain was significantly reduced. The average postoperative Quick Disabilities of the Arm, Shoulder, and Hand score was 19, and the return-to-work rate was 90%. Radiographic analysis showed union in all patients, improvement of carpal height and scaphoid angle, no evidence of ulnar translation, and a 30% rate of radiocarpal osteoarthritis.
  
  
  CONCLUSIONS
  This report of long-term results demonstrates the efficacy of scaphocapitate limited carpal arthrodesis for the treatment of chronic rotatory subluxation of the scaphoid. We conclude that continued use of this procedure is warranted.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Institut Français de Chirurgie de la Main, Paris, France.
authors.forename: Matthias
authors.initials: M
authors.lastname: Luegmair
authors.forename: Philippe
authors.initials: P
authors.lastname: Saffar
mesh_terms: D000062:Accidents, Occupational; D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D051224:Capitate Bone / Q000601:surgery*; D005260:Female; D018737:Hand Strength; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000601:surgery*; D014057:Tomography, X-Ray Computed