Clinical trial NCT05362240: Outcomes of Three Corner Fusion Without Triquetrum Excision Versus Conventional Four Corner Fusion in SNAC Wrist
Official title: Functional Outcomes of Three Corner Fusion Without Triquetrum Excision Versus Conventional Four Corner Fusion in Scaphoid Non Union Advanced Collapse (SNAC) Wrist Grade II and III : a Prospective Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Scaphoid Fracture
Keywords: SNAC wrist
Four-corner fusion
Three corner fusion
Lead sponsor: Ain Shams University
Sponsor class: OTHER
First posted: 2022-05-05
Enrollment: 34
Sex: ALL
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Two groups with the first intervention four corner fusion , and the second with three corner fusion without triquetrum excision
Primary purpose: TREATMENT

Brief summary: The investigator compare two types of limited wrist arthrodesis used for management of cases with scaphoid non union advanced collapse (SNAC) as regard the outcome to provide the most suitable technique

Detailed description: There is a controversy regarding the suitable limited wrist arthrodesis technique for SNAC wrist grade II and III . For several decades , scaphoid excision and four corner fusion (between lunate , capitate , hamate and triquetrum) was the gold standard with good functional outcomes . Later on , a more limited fusion technique was described , three corner fusion ( between lunate , capitate and hamate) with scaphoid and triquetrum excision to improve ulnar deviation range . On the other hand , biomechanical studies mentioned that the triquetrum had a certain proprioceptive function that could be affected when it was included in the fusion process .Furthermore , if the triquetrum was excised the radiolunate contact pressure would increase with higher risk of development of arthritis. The aim of the study to compare the conventional four corner fusion with three corner fusion with triquetrum excision

Eligibility criteria: Inclusion Criteria:

* SNAC wrist G II , III

Exclusion Criteria:

* cases with radiolunate arthritis
* Scapholunate advanced collapse
* Grade 1 Scaphoid non union advanced collapse
* Kienbock disease
* Skeletally immature patients

Primary outcomes:
measure: Range of motion
timeFrame: preoperative
measure: Range of motion
timeFrame: one year postoperative
measure: Power grip
timeFrame: preoperative
measure: Power grip
timeFrame: one year postoperative
Secondary outcomes:
measure: operative time
timeFrame: Intraoperative
measure: Visual analogue scale
timeFrame: preoperative
measure: Visual analogue scale
timeFrame: one year postoperative
measure: Patient satisfaction
timeFrame: preoperative
measure: Patient satisfaction
timeFrame: one year postoperative
Other outcomes:
Locations:
city: Al 'Abbāsīyah
country: Egypt
facility: Ain Shams University , Faculty of medicine
state: Cairo
Study officials:
affiliation: Ain Shams University
name: Mohamed M Elmahy, Professor
role: STUDY_CHAIR
References:
citation: Bain GI, Sood A, Ashwood N, Turner PC, Fogg QA. Effect of scaphoid and triquetrum excision after limited stabilisation on cadaver wrist movement. J Hand Surg Eur Vol. 2009 Oct;34(5):614-7. doi: 10.1177/1753193408094923. Epub 2009 Jul 10.
citation: Scobercea RG, Budoff JE, Hipp JA. Biomechanical effect of triquetral and scaphoid excision on simulated midcarpal arthrodesis in cadavers. J Hand Surg Am. 2009 Mar;34(3):381-6. doi: 10.1016/j.jhsa.2008.11.027.
citation: Delattre O, Goulon G, Vogels J, Wavreille G, Lasnier A. Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis. J Hand Surg Am. 2015 Nov;40(11):2176-82. doi: 10.1016/j.jhsa.2015.07.032. Epub 2015 Sep 26.