Isolated or predominant capitolunate osteoarthritis is the consequence of lunotriquetral dissociation. X-ray analysis of 22 consecutive cases.
Secondary osteoarthritis due to a scapholunate malalignment is well known, but is debatable in cases of lunotriquetral malalignment. It has been shown that lunotriquetral malalignment can lead to midcarpal osteoarthritis. The hypothesis of this retrospective study was that a relationship exists between the presence of midcarpal osteoarthritis and the presence of lunotriquetral malalignment. All patients with midcarpal osteoarthritis, isolated or predominant, treated between 1981 and 2013 were reviewed. Intracarpal angles were measured and the relative position of the carpal bones was analyzed by two examiners. Osteoarthritis of the wrist's joints was quantified in three stages. Diagnosis of static dissociative ligament lesion was made and correlated with the location of osteoarthritis. Twenty-two wrists in 20 patients (13 men and 7 women; mean age of 59 years) were included. The lunocapitate osteoarthritis was moderate in 6 cases and severe in 16 cases. The radioscaphoid osteoarthritis was moderate in 5 cases and severe in 1 case. Lunotriquetral malalignment was present in all cases; it was isolated in 8 cases and associated with scapholunate malalignment in 14 cases. In isolated lunotriquetral malalignment cases, midcarpal osteoarthritis was isolated or associated with degenerative lesions of lunotriquetral interval. Cases of perilunate instability in which the osteoarthritis is more severe in the midcarpal joint than in the radioscaphoid joint likely resulted from an injurying mechanism with ulnar beginning (ulnar-sided perilunate instability).
Unité de chirurgie de la main et du membre supérieur, Services de chirurgie orthopédique 1 et 2, Hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France.
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Brunet
Unité de chirurgie de la main et du membre supérieur, Services de chirurgie orthopédique 1 et 2, Hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France.
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Bacle
Unité de chirurgie de la main et du membre supérieur, Services de chirurgie orthopédique 1 et 2, Hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France.
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Marteau
Unité de chirurgie de la main et du membre supérieur, Services de chirurgie orthopédique 1 et 2, Hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France.
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Gadea
Unité de chirurgie de la main et du membre supérieur, Services de chirurgie orthopédique 1 et 2, Hôpital Trousseau, CHRU de Tours, avenue de la République, 37170 Chambray-lès-Tours, France. Electronic address: jacky.laulan@wanadoo.fr.
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Laulan
D000328:Adult; D000368:Aged; D001175:Arthrography; D051224:Capitate Bone / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D012667:Lunate Bone / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000209:etiology; D012189:Retrospective Studies; D051221:Triquetrum Bone / Q000000981:diagnostic imaging*; D014955:Wrist Joint / Q000000981:diagnostic imaging*; D014965:X-Rays
Arthrose médiocarpienne; Floating lunate; Instabilité luno-triquétrale; Instabilité périlunaire; Instabilité scapho-lunaire; Lunatum flottant; Lunotriquetral instability; Midcarpal osteoarthritis; Scapholunate instability; Ulnar-sided perilunate instability