RESEARCH - Radiolunate fusion with distraction using cortiocancellous bone graft for minimizing decrease of wrist motion in RA

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Hand Surg. 2009;14(1):15-21.

Radiolunate fusion with distraction using corticocancellous bone graft

for minimizing decrease of wrist motion in rheumatoid wrists.

Masuko T, Iwasaki N, Ishikawa J, Kato H, Minami A.

Department of Orthopaedic Surgery, Hokkaido University Graduate School

of Medicine, Sapporo, Japan.

Radiolunate fusion is a limited carpal fusion procedure used for

patients with rheumatoid arthritis. However, this procedure inevitably

causes decreases in range of motion, especially wrist flexion.

Linscheid and Dobyns described the possibility of minimizing the

decrease in motion at the radiocarpal joint by slight distraction of

the joint. We hypothesized for our modified procedure that a

corticocancellous bone graft was inserted between the radius and the

lunate with a small amount of over-correction could provide slight

distraction of radioscaphoid joint and protect the joint from

decreased range of motion after arthrodesis. Twelve wrists in ten

patients with rheumatoid arthritis underwent radiolunate fusion. Mean

age at operation was 53 years old and mean follow-up period was 5.7

years. Clinical evaluation and radiological assessment showed that

decrease in range of motion was minimized compared with other

procedures. Because our modified procedure can minimize decrease in

motion, it is recommended.

PMID: 19598316

http://www.ncbi.nlm.nih.gov/pubmed/19598316

Not an MD