Treatment of scaphotrapezial trapezoidal osteoarthritis with resection of the distal pole of the scaphoid

Abstract

Objective: The aim of this study was to describe the surgical technique for resection of the distal quarter of the scaphoid and compare the results of patients treated by resection with patients treated by resection with insertion of a pyrocarbon implant. Methods: The study included 9 wrists treated by resection-only and 8 wrists treated by resection with implant. Average follow-up period was 77 (range: 24 to 130) months. Wrist motion and pinch strength were measured and pain was evaluated using the visual analog scale (VAS). Radiographic classification was performed according to Crosby's classification system and the radiolunate (RL) angle was measured pre- and postoperatively. Results: Postoperative VAS pain scores were 2.1 and 2.6 in the in the resection-only and implant group, respectively. Pain scores decreased significantly in both groups (p=0.007 and p=0.01, respectively). The mean RL angle increased from 14 degrees to 30 degrees in the resection-only group (p=0.008). In the STPI implant group, there was an increase in the mean RL angle from 21 degrees to 23 degrees; however, this difference was not significant (p=0.75). Conclusion: Application of a pyrocarbon implant appears to be useful for pain relief and may help prevent secondary deformities in the treatment of scaphotrapezial trapezoidal arthritis.