title: Bicolumnar intercarpal arthrodesis: minimum 2-year follow-up.
abstract: OBJECTIVE
  To determine greater than 2-year outcomes for combined lunate-capitate and triquetrum-hamate arthrodeses.
  
  
  METHODS
  We identified 16 patients who underwent scaphoid excision and combined arthrodeses of the lunate-capitate and triquetrum-hamate joints (bicolumnar arthrodesis) from 2007 to 2010. Eleven patients returned for follow-up evaluation, which included measurement of operative and contralateral control wrist flexion, extension, and grip strength, and completion of a patient-reported outcomes questionnaire, visual analog scale pain assessment, and Disabilities of the Arm, Shoulder, and Hand questionnaire. Radiographs of each patient were reviewed for evidence of union. Complications including nonunion and hardware migration were recorded.
  
  
  RESULTS
  Wrist flexion-extension in the operative wrist was 68% of the contralateral control wrist. Grip strength of the operative wrist was 97% of the contralateral wrist. All 11 patients had radiographic bicolumnar union; 8 patients had spontaneous radiographic fusion of the capitohamate joint. One patient required capitolunate screw removal for migration despite having evidence of union.
  
  
  CONCLUSIONS
  Results from scaphoid excision and bicolumnar intercarpal arthrodesis are comparable to those reported for traditional scaphoid excision and 4-corner arthrodesis, with a similar loss of wrist range of motion and with possible preservation of better grip strength in the operative wrist. Advantages of this modification include preservation of the normal lunate-triquetrum and capitate-hamate anatomic relationships and simplification of operative technique.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Mary S. Stern Hand Surgery Fellowship, Cincinnati, OH; Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC.
authors.forename: Reid W
authors.initials: RW
authors.lastname: Draeger
authors.affiliation: Mary S. Stern Hand Surgery Fellowship, Cincinnati, OH; Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC.
authors.forename: Donald K
authors.initials: DK
authors.lastname: Bynum
authors.affiliation: Mary S. Stern Hand Surgery Fellowship, Cincinnati, OH; Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC.
authors.forename: Alicia
authors.initials: A
authors.lastname: Schaffer
authors.affiliation: Mary S. Stern Hand Surgery Fellowship, Cincinnati, OH; Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address: megan_patterson@med.unc.edu.
authors.forename: J Megan M
authors.initials: JM
authors.lastname: Patterson
mesh_terms: D001174:Arthrodesis / Q000379:methods*; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*
keywords: 4-corner arthrodesis; Arthrodesis; midcarpal arthrodesis; scaphoid nonunion advanced collapse; scapholunate advanced collapse