Resection of the distal scaphoid for scaphotrapeziotrapezoid osteoarthritis

Twenty-one patients with symptomatic scaphotrapeziotrapezoid osteoarthritis were treated with partial distal scaphoid escision. fn 12 wrists the joint defect was filled with either capsular or tendinous tissue, while in nine no fibrous interposition was done. At an average follow-up time of 29 (rang e, 12-61) months, 13 wrists were painfree, while eight had occasional mild discomfort. Mean wrist flexion-extension was 119 degrees. Grip and pinch st rength improved bg an average of 26% and 40% respectively compared with the ir preoperative status, Fifteen patients returned to their original jobs, w hile six, who were unemployed, felt unrestricted for activities of daily li ving. Although patient satisfaction nas comparable for both types of treatm ent, the wrists Without fibrous interposition showed significantly greater wrist flexion-extension than patients with soft-tissue interposition. Remov al of the distal scaphoid resulted in a DISI pattern of carpal malalignment in 12 wrists. At follow-up, none of these wrists showed further joint dete rioration due to residual malalignment.