Radioscapholunate fusion in kienböck’s disease

Abstract

Radioscapholunate (RSL) fusion is a partial wrist fusion for patients with localized arthritis of the wrist, such as those with Kienböck’s disease. An essential prerequisite is a well-preserved midcarpal joint, which can be confirmed on imaging, arthroscopy or intra-operatively. Cadaveric and clinical studies of RSL fusions demonstrate that excision of the distal scaphoid improves motion of a RSL fusion and has a better union rate. Other studies have also included excision of the triquetrum, demonstrating an increase in the radioulnar arc. There are a variety of fixation options, such as K-wires, staples, and plate fixation. Long-term follow-up of our RSL fusions included three patients with Kienböck’s disease. Their outcomes were assessed using the visual analogue scale, Quick DASH, Mayo wrist score, measured ROM, and plain radiographs. All patients demonstrate good patient satisfaction, clinical outcomes, and preservation of the midcarpal articulation.