Radioscapholunate fusion using Medartis plate with distal Scaphoid excision
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This is a detailed step by step instruction through a Radio-scapho-lunate fusion with distal scaphoid excision using a dorsal low profile titanium plate from MedartisTM.
This is a salvage operation usually undertaken when the radio-scaphoid and or radio-lunate joints are damaged and arthritic. This occurs following distal radius fracture, rheumatoid arthritis, Keinbock’s or a Scapholunate advanced collapse (SLAC) stage 2.
The mid-carpal joint must be preserved to undertake this surgery.
Following a period of 6-8 weeks in plaster cast and the rehabilitation it is expected the patient will achieve a total arc of flexion and extension of around 60 degree. The operation has a non-union rate of around 10%.
Author: Mr Mark Brewster FRCS (Tr & Orth)
Institution: The Royal Orthopaedic Hospital, Birmingham ,UK.