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Scaphotrapeziotrapezoid arthrodesis: A follow-up study

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Presentation on theme: "Scaphotrapeziotrapezoid arthrodesis: A follow-up study"— Presentation transcript:

1 Scaphotrapeziotrapezoid arthrodesis: A follow-up study
H.Kirk Watson, MD, Ronit Wollstein, MD, Emmanuella Joseph, MD, Richard Manzo, MD, Jeffrey Weinzweig, MD, Duffield Ashmead, MD  Journal of Hand Surgery  Volume 28, Issue 3, Pages (May 2003) DOI: /jhsu Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

2 Fig. 1 A Kellegren-Lawrence score of 0 was determined for this 29-year-old occupational therapist 5 years after STT arthrodesis for dynamic rotary subluxation of the scaphoid. Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

3 Fig. 2 A Kellegren-Lawrence score of 1 was determined for this 45-year-old man 5.5. years after STT arthrodesis for Kienbock's disease. The lunate was revascularized. Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

4 Fig. 3 A Kellegren-Lawrence score of 2 was determined for this 63-year-old man 13.3 years after STT arthrodesis for dynamic rotary subluxation of the scaphoid. Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

5 Fig. 4 A Kellegren-Lawrence score of 3 was determined for this 46-year-old woman 1.4 years after STT arthrodesis for Kienbock's disease. Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

6 Fig. 5 A Kellegren-Lawrence score of 4 was determined for this 69-year-old man 16 years after STT arthrodesis for rotary subluxation of the scaphoid with early SLAC changes. This patient was excluded from statistical analysis of secondary degenerative arthritis because of the preexisting arthritic changes. Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

7 Fig. 6 The key surgical issue is scaphoid position. Normally the scaphoid lies 47° to the long axis of the radius. In rotary subluxation of the scaphoid it can collapse past 90°. Fusing the STT joint changes wrist mechanics and requires greater than normal flexion of the scaphoid, ideally to 55° to 60° Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

8 Fig. 7 (A, B) A properly positioned scaphoid maintains good motion as seen in this 43-year-old 14 years after STT arthrodesis. Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

9 Fig. 8 This intraoperative view shows loss of articular cartilage on the scaphoid at the time of STT fusion in a professional basketball player in Figure 6. Note complete absence of the scapholunate ligament. S, scaphoid; l, lunate. Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions

10 Fig. 9 The patients' follow-up periods were distributed among 1 year and 9 years. Journal of Hand Surgery  , DOI: ( /jhsu ) Copyright © 2003 American Society for Surgery of the Hand Terms and Conditions


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