Douglas D P, Peimer C A, Koniuch M P
Department of Orthopaedic Surgery, State University of New York, Buffalo 14214.
J Bone Joint Surg Am. 1987 Dec;69(9):1413-8.
Seven different types of intercarpal arthrodeses that are commonly used in clinical practice were simulated in wrists of cadavera by drilling two nonparallel Kirschner wires across the involved joint that was to be fused. The changes in radial deviation, ulnar deviation, dorsiflexion, and palmar flexion, and the arc of motion in two planes (radial plus ulnar deviation and dorsiflexion plus palmar flexion) were compared with control values for each specimen and with each of the other arthrodeses. All of the data were analyzed by calculating the mean and standard error of the changes in these motions of the wrist as compared with the control values for each wrist. The statistical significance of the changes was derived by the t test. For values of t greater than 2.262, the observed mean reductions in the motions were statistically significant (p = 0.05) in all wrists except those that had simulated arthrodesis of the lunate-triquetrum or the capitate-hamate joint. No statistically significant differences were noted between the effects of arthrodesis of the scaphoid-trapezium-trapezoid, scaphoid-capitate, and scaphoid-lunate joints on the motions of the wrist. All arthrodeses except those of the lunate-triquetrum and the capitate-hamate joint produced a statistically significant decrease in the total arc of motion; arthrodesis of the capitate-lunate joint produced the most statistically significant decrease in total arc of motion. In our opinion, the results of the study suggest that there is limited justification for arthrodesis of the capitate-hamate joint.(ABSTRACT TRUNCATED AT 250 WORDS)
