MOTION-PRESERVING PROCEDURES IN THE TREATMENT OF SCAPHOLUNATE ADVANCED COLLAPSE WRIST - PROXIMAL ROW CARPECTOMY VERSUS 4-CORNER ARTHRODESIS

Seventeen patients were treated with scaphoid excision and four-corner arthrodesis (lunate, capitate, hamate, triquetrum) for scapholunate a dvanced collapse wrist and followed for a mean of 27 months. Eleven wr ists in 10 patients had a proximal row carpectomy for scapholunate adv anced collapse wrist and were followed for a mean of 37 months. The to tal are of motion averaged 95 degrees in the four-corner arthrodesis p atients and 115 degrees in the proximal row carpectomy patients, which was 47% and 64%, respectively, of the range of motion of the opposite wrist. Grip strength averaged 74% of the opposite wrist in the four-c orner arthrodesis group and 94% in the proximal row carpectomy group. Three wrists in the four-corner arthrodesis group failed and were succ essfully converted to a total wrist fusion; two additional patients ar e awaiting arthrodesis. There were no failures in the proximal row car pectomy group. Proximal row carpectomy showed a high degree of patient satisfaction and is our motion-preserving procedure of choice except in those wrists with advanced capitolunate arthritis.