title: Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis.
abstract: OBJECTIVE
  To report the clinical and radiographic results of a consecutive series of patients who underwent the 3-corner arthrodesis (3CA) (arthrodesis of capitate, hamate, and lunate with scaphoid and triquetrum excision) procedure for wrist arthritis.
  
  
  METHODS
  This was a retrospective study of 30 consecutive patients who underwent a 3CA between 1994 and 2008. The indications were painful wrist osteoarthritis due to stage 2 or 3 scapholunate advanced collapse, scaphoid nonunion advanced collapse, or scaphoid chondrocalcinosis advanced collapse wrists. The clinical assessment consisted of range of motion, grip strength, and the Disabilities of the Arm, Shoulder, and Hand and Patient-Rated Wrist Evaluation scores. The radiographic assessment parameters consisted of bone fusion, carpal height and translation, lunate tilt, and appearance of the radiolunate joint space.
  
  
  RESULTS
  The average follow-up was 6 years (± 4 years). The arthrodesis was performed with staples, 2 screws, or a plate and screws. Grip strength was 72% of the contralateral side. The mean range of motion in flexion-extension arc and ulnar-radial deviation arc was 70° and 36°, respectively. The mean Disabilities of the Arm, Shoulder, and Hand and the Patient-Rated Wrist Evaluation scores were 17 (± 11) and 22 (± 24), respectively. The fusion incidence was 90% (27 of 30). The mean difference of radiolunate angle on preoperative and postoperative radiographs was 8° (16°-8° in dorsal direction). The radiolunate joint space had narrowed in 1 patient. Six surgical revisions (20%) were necessary owing to dorsal pain in patients operated using plates, staples, or excessively long screws.
  
  
  CONCLUSIONS
  Three-corner arthrodesis results are comparable with 4-corner arthrodesis and proximal row carpectomy. We feel that it is simpler technically than 4-corner arthrodesis. Although 3CA is more complex than proximal row carpectomy, it preserves the native radiolunate joint. Complications that can be attributed to the dorsal fixation hardware (particularly staples and plates) were noteworthy.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Delattre
authors.affiliation: Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Goulon
authors.affiliation: Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Vogels
authors.affiliation: Clinique Lille-Sud, Lesquin, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Wavreille
authors.affiliation: Service de Chirurgie Orthopédique et Traumatologique du membre supérieur, Centre Hospitalier Universitaire Pierre Zobda Quitman, Fort-de-France, Martinique, France. Electronic address: drarthurlasnier@gmail.com.
authors.forename: Arthur
authors.initials: A
authors.lastname: Lasnier
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D001863:Bone Screws; D004185:Disability Evaluation; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D051221:Triquetrum Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Arthritis; arthrodesis; three-corner fusion; triquetrum excision; wrist