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There are two types of interventions to treat a post-traumatic wrist osteoarthritis: the proximal row carpectomy and the four corner fusion. They are used to reduce pain and to maintain the mobility. In previous studies are shown that the proximal row carpectomy shows a better mobility of the wrist postoperatively, whereas the four corner fusion has lower progression of radiocarpale osteoarthritis.
The purpose of this study is to compare the clinical, radiological and subjective outcomes after the treatment with a proximal row carpectomy or a four corner fusion.
Two surgical procedures are used to treat a post-traumatic wrist osteoarthritis, especially after scaphoid non-union advanced collapse (SNAC) and scapholunate advanced collapse (SLAC): the proximal row carpectomy and the four corner fusion. Both surgical procedures are rescue operations. They are used to reduce pain and to maintain the mobility, compared to a complete stiffening of the wrist.
In previous studies are shown that the proximal row carpectomy shows a better mobility of the wrist postoperatively and a lower complication rate, whereas the four corner fusion has a lower progression of radiocarpale osteoarthritis and a better grip strength.
The purpose of this study is to compare the clinical, radiological and subjective outcomes after the treatment with a proximal row carpectomy or a four corner fusion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| proximal row carpectomy | patients were treated with a proximal row carpectomy |
| |
| four corner fusion | patients were treated with a four corner fusion |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| proximal row carpectomy | Procedure | excision of the scaphoid, lunate and triquetrum |
|
| Measure | Description | Time Frame |
|---|---|---|
| Range of motion of the wrist | measurements of flexion/extension,supination/pronation and radial-/ulnarduction of the wrist | participants will be followed up by an expected average of 4.5 years |
| Measure | Description | Time Frame |
|---|---|---|
| complication rate | Detection of complications of both surgical procedures | participants will be followed up by an expected average of 4.5 years |
| Measure | Description | Time Frame |
|---|---|---|
| grip strength | measurement of grip strength | participants will be followed up by an expected average of 4.5 years |
| Patient-Rated Wirst Evaluation (PRWE) | Comparison of proximal row carpectomy and four corner fusion in respect to PRWE |
Inclusion Criteria:
Exclusion Criteria:
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patients with a post-traumatic wrist osteoarthritis, who are treated with a proximal row carpectomy or a four corner fusion
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| Name | Affiliation | Role |
|---|---|---|
| Daniel B Herren, Dr. med. | Schulthess Klinik | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Schulthess Klinik | Zurich | Canton of Zurich | 8008 | Switzerland |
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| four corner fusion | Procedure | excision of the scaphoid and stiffening of the lunate, capitate and triquetrum by a plate |
|
| participants will be followed up by an expected average of 4.5 years |
| Michigan Hand Outcomes Questionnaire (MHQ) | Comparison of proximal row carpectomy and four corner fusion in respect to MHQ | participants will be followed up by an expected average of 4.5 years |
| Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) | Comparison of proximal row carpectomy and four corner fusion in rsespect to QuickDASH | participants will be followed up by an expected average of 4.5 years |
| Detection of radiological parameters | Detection of arthrosis fossa lunata, impingement and loosening | participants will be followed up by an expected average of 4.5 years |