Proximal Row Carpectomy Versus Four Corner Fusion

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Comparison of Subjective, Radiological and Functional Results After Proximal Row Carpectomy and Four Corner Fusion

Conditions
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Wrist Osteoarthritis

Intervention / Treatment
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* Procedure: proximal row carpectomy
* Procedure: four corner fusion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: post-traumatic wrist osteoarthritis treated with a proximal row carpectomy or four corner fusion signed written informed consent Exclusion Criteria: no knowledge of German

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| proximal row carpectomy<br>patients were treated with a proximal row carpectomy | Procedure: proximal row carpectomy<br>* excision of the scaphoid, lunate and triquetrum<br>|
| four corner fusion<br>patients were treated with a four corner fusion | Procedure: four corner fusion<br>* excision of the scaphoid and stiffening of the lunate, capitate and triquetrum by a plate<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | 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 | 

Secondary Outcome Measures

| Outcome Measure | 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 |