Journal of Orthopaedic Reports (Dec 2023)

Single versus double columnar limited arthrodesis for management of type 2 SLAC and SNAC wrists: Retrospective comparative study

  • Ahmed Fathy Sadek,
  • Tarek Ali Abd Elaziz,
  • Ibrahim Elhawary Ali,
  • Hisham Ali Elsherif,
  • Ahmed Nady Saleh Elsaid,
  • Mohamed Elshafie

Journal volume & issue
Vol. 2, no. 4
p. 100220

Abstract

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Introduction: In selected cases of degenerative wrist arthritis, with spared radio-lunate articulation, motion preserving procedures provide viable and reproducible options. The authors have compared single and double columnar arthrodesis in management of grade 2 degenerative wrist arthritis regarding final functional outcomes and potential complications.Patients and methods: forty patients were eligible for review where a retrospective comparative single center study was conducted between two groups including cases of degenerative wrist arthritis type 2 SNAC or SLAC [group 1 included 17 (SNAC) and 3 (SLAC) cases while group 2 included 15 (SNAC) and 5 (SLAC) cases]. Group 1 patients were managed by single columnar arthrodesis “SCA” (20 patients, 15 male and 5 female with a mean age of 38.4 ± 12.3 years) while group 2 patients were managed by double columnar arthrodesis “DCA” (20 patients, 16 male and 4 female with a mean age of 36.2 ± 11.17 years). Results: The mean time needed for union of the arthrodesis was comparable in both groups [2.9 ± 1.6 versus 2.7 ± 1.7 months in groups 1 and 2 respectively; p = 0.475]. The union rate was 95% in both groups. The postoperative clinical parameters in both groups, including DASH, modified Mayo wrist scores, VAS, flexion/extension and active ROM, showed no statistically significant differences. Group 1 had statistically better postoperative radial/ulnar active ROM than Group 2 (p < 0.001). The use of headless compression screws (HCSs) has been associated with significantly shorter union time. Both HCSs fixation and shorter union time have shown significant positive correlation to good functional outcome (p = 0.027 and 0.046 respectively). Conclusions: the application of SCA or DCA provides an appealing option for management of degenerative wrist arthritis with high union rates up to [95%] and good functional range of motion.

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