Randomized clinical trial between proximal row carpectomy and the four-corner fusion for patients with stage II SNAC.
OBJECTIVE
To compare the outcomes of patients with stage II SNAC submitted to surgical treatment by proximal row carpectomy (PRC) or four-corner fusion (FCF).


METHODS
Twenty-seven patients aged 18-59 years (mean 37.52 years) were included. Thirteen patients underwent PRC in Group A, and 14 underwent FCF of the wrist in Group B. Evaluations were made before and after surgery with follow-up between 45 and 73 months. Range of motion (ROM); pain assessment with a visual analog scale (VAS); grip strength; disability of the arm, shoulder, and hand (DASH); and return to work were evaluated.


RESULTS
Group A patients had 68.5% and Group B patients, 58.01% of the ROM of the contralateral side. The VAS score was 2.3 in Group A and 2.9 in Group B. Grip strength was 78.67% and 65.42%, respectively, relative to the side not affected. The DASH score was 11 for PRC and 13 for FCF. In Group A, 9/13 (69.23%) and in Group B, 8/14 (57.14%) patients are currently working. Complications were symptomatic osteoarthritis in the mid-carpal joint in Group A and loosening of a screw in Group B.


CONCLUSIONS
The clinical and functional results do not present statistically significant differences for both analyzed methods.
Faculdade de Medicina do ABC, Departamento de Ortopedia e Traumatologia, Santo André, SP, Brazil.
Marcio Aurelio
MA
Aita
Faculdade de Medicina do ABC, Departamento de Ortopedia e Traumatologia, Santo André, SP, Brazil.
Edison Kenji
EK
Nakano
Faculdade de Medicina do ABC, Departamento de Ortopedia e Traumatologia, Santo André, SP, Brazil.
Henrique de Lazari
HL
Schaffhausser
Faculdade de Medicina do ABC, Departamento de Ortopedia e Traumatologia, Santo André, SP, Brazil.
Walter Yoshinori
WY
Fukushima
Faculdade de Medicina do ABC, Departamento de Ortopedia e Traumatologia, Santo André, SP, Brazil.
Edison Noboru
EN
Fujiki
Arthrodesis; Pain; Scaphoid bone; Wrist