Outcomes of Three Corner Fusion Without Triquetrum Excision Versus Conventional Four Corner Fusion in SNAC Wrist

Not Applicable

Completed

• Conditions: Scaphoid Fracture
• Interventions: Procedure: Four corner fusion; Procedure: three corner fusion without triquetrum excision

• Registration Number: NCT05362240
• Lead Sponsor: Ain Shams University

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

Study Timeline

• Study Start: 2018-09-20
• Primary Completion: 2021-10-30
• Study Completion: 2021-12-02
• Status Verified: 2022-05
• Study First Submitted: 2022-05-02
• Study First Submitted QC: 2022-05-04
• Last Update Submitted: 2022-05-04
• Study First Posted: 2022-05-05
• Last Update Posted: 2022-05-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 34

Inclusion Criteria

• SNAC wrist G II , III

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Exclusion Criteria

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

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Four corner fusion	Four corner fusion	Scaphoid excision and fusion between lunate , capitate , hamate and triquetrum using k.wires
Three corner fusion without triquetrum excision	three corner fusion without triquetrum excision	Scaphoid excision with fusion between lunate , capitate and hamate with preservation of triquetrum

Primary Outcome Measures

Name	Time	Method
Range of motion	one year postoperative	measuring range of motion and sagittal and coronal plane using goniometer
Power grip	one year postoperative	Using dynamometer , take the average of three successive measures for injured side and normal side . The grip strength recorded as number between 1-30 (per square inch ) and as a percentage to the contralateral side

Secondary Outcome Measures

Name	Time	Method
Patient satisfaction	one year postoperative	Modified Mayo wrist score which involves both patient and physician participation. The scale runs from 0 to 100, with 0 representing a worse wrist condition and 100 suggesting a better wrist condition. It assess discomfort, active flexion/extension arc (in contrast to the contralateral side), grip strength (in comparison to the contralateral side), and the capacity to return to regular job or activities.
operative time	Intraoperative	measuring the operative time
Visual analogue scale	one year postoperative	Pain assessment using the scale from 0 to 10 , with 0 no pain , 5 moderate pain , 10 worst possible pain .

Trial Locations

Locations (1)

Ain Shams University , Faculty of medicine; 🇪🇬 Al 'Abbāsīyah, Cairo, Egypt