Funktionelle Ergebnisse nach mediokarpaler Teilarthrodese als Behandlungskonzept bei fortgeschrittenem karpalem Kollaps (SNAC-/SLAC-Wrist)

Abstract

The purpose of this retrospective study was the evaluation of the functional outcome of midcarpal arthrodesis, its results in the treatment of SNAC/SLAC stage II and III and patients' satisfaction. 49 patients that were treated with a midcarpal arthrodesis were re-examined at a mean follow-up time of 47 months. Range of motion was verified and grip strength was measured with a Jamar-Dynamometer II and a pinch-grip. Pain was evaluated by a visual analogue scale (VAS 0 to 100) for stress and under resting conditions. Patients' daily activities and general quality of life were estimated with the DASH questionnaire. Radiographic evaluation was done by conventional X-ray. Active range of motion was 56 % and grip strength was 76 % of the non-operated wrist. The DASH score was 29 points. Pain relief was 34 % during resting conditions and 31 % after stress respectively. 45 patients demonstrated bony consolidation in X-ray control. Six patients needed further treatment with a total arthrodesis because of pain or absence of bony consolidation. 77 % of the patients returned to their original occupation and 80 % were satisfied with the final result. Our data demonstrate that midcarpal fusion is a reliable procedure for treating the difficult condition of advanced carpal collapse if proper realignment of the carpus is performed.