TY - JOUR
T1 - Radioscapholunate Arthrodesis and Distal Radioulnar Joint Arthroplasty for Rheumatoid Wrist Arthritis
T2 - A Surgical Technique
AU - Samade, Richard
AU - Adapa, Nikhil
AU - Roebke, Austin J.
AU - Awan, Hisham M.
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/9/22
Y1 - 2022/9/22
N2 - Introduction: We describe the treatment of rheumatoid radiocarpal joint and distal radioulnar joint (DRUJ) arthritis with radioscapholunate (RSL) arthrodesis and DRUJ arthroplasty in 2 patients with 2 years follow-up. The RSL arthrodesis utilizes nitinol staples and local distal radius autograft to fuse the scaphoid and lunate to the distal radius. Materials and Methods: One patient was treated in their nondominant extremity, and the other patient had bilateral procedures. A constrained endoprosthesis was used for the DRUJ arthroplasty portion, using the same dorsal approach to the wrist as the RSL arthrodesis. Results: Before his procedures, this first patient-reported a Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score of 66, which improved to 16 at 2 years postoperatively. He also reported a Visual Analog Scale score of 6/10 at rest in both wrists preoperatively. Following his procedures, Visual Analog Scale scores improved to 3/10 in the right wrist and 0/10 in the left wrist. Active wrist range of motion was measured to be a 60-degree arc on the right and a 47-degree arc on the left. Our second patient reported an improved QuickDASH score from 97 preoperatively to 68 at 2 years postoperatively and had a 70-degree arc of left wrist range of motion. No postoperative complications or reoperations were encountered in the cases. Discussion: The benefit of this technique is to allow simultaneous treatment of radiocarpal joint arthritis with RSL arthrodesis, permitting wrist flexion and extension through the midcarpal joints, and DRUJ arthritis with DRUJ arthroplasty, preserving pronation and supination.
AB - Introduction: We describe the treatment of rheumatoid radiocarpal joint and distal radioulnar joint (DRUJ) arthritis with radioscapholunate (RSL) arthrodesis and DRUJ arthroplasty in 2 patients with 2 years follow-up. The RSL arthrodesis utilizes nitinol staples and local distal radius autograft to fuse the scaphoid and lunate to the distal radius. Materials and Methods: One patient was treated in their nondominant extremity, and the other patient had bilateral procedures. A constrained endoprosthesis was used for the DRUJ arthroplasty portion, using the same dorsal approach to the wrist as the RSL arthrodesis. Results: Before his procedures, this first patient-reported a Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score of 66, which improved to 16 at 2 years postoperatively. He also reported a Visual Analog Scale score of 6/10 at rest in both wrists preoperatively. Following his procedures, Visual Analog Scale scores improved to 3/10 in the right wrist and 0/10 in the left wrist. Active wrist range of motion was measured to be a 60-degree arc on the right and a 47-degree arc on the left. Our second patient reported an improved QuickDASH score from 97 preoperatively to 68 at 2 years postoperatively and had a 70-degree arc of left wrist range of motion. No postoperative complications or reoperations were encountered in the cases. Discussion: The benefit of this technique is to allow simultaneous treatment of radiocarpal joint arthritis with RSL arthrodesis, permitting wrist flexion and extension through the midcarpal joints, and DRUJ arthritis with DRUJ arthroplasty, preserving pronation and supination.
KW - arthroplasty
KW - distal radioulnar joint
KW - radiocarpal fusion
KW - rheumatoid arthritis
KW - Scheker procedure
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U2 - 10.1097/BTO.0000000000000566
DO - 10.1097/BTO.0000000000000566
M3 - Article
AN - SCOPUS:85112445362
SN - 0885-9698
VL - 37
SP - 159
EP - 165
JO - Techniques in Orthopaedics
JF - Techniques in Orthopaedics
IS - 3
ER -