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

NCT05362240 | Completed DMC

• 1 other identifier: FMASU M D 296/2019
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

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

Conditions

Scaphoid Fracture

Keywords

SNAC wrist; Four-corner fusion; Three corner fusion

Outcome Measures

Primary Outcomes (4)

• Range of motion

  measuring range of motion and sagittal and coronal plane using goniometer

  preoperative

• Range of motion

  measuring range of motion and sagittal and coronal plane using goniometer

  one year postoperative

• Power grip

  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

  preoperative

• Power grip

  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

  one year postoperative

Secondary Outcomes (5)

• operative time

  Intraoperative

• Visual analogue scale

  preoperative

• Visual analogue scale

  one year postoperative

• Patient satisfaction

  preoperative

• Patient satisfaction

  one year postoperative

Study Arms (2)

Four corner fusion

EXPERIMENTAL

Scaphoid excision and fusion between lunate , capitate , hamate and triquetrum using k.wires

Procedure: Four corner fusion

Three corner fusion without triquetrum excision

EXPERIMENTAL

Scaphoid excision with fusion between lunate , capitate and hamate with preservation of triquetrum

Procedure: three corner fusion without triquetrum excision

Interventions

Four corner fusion PROCEDURE

First , we inspected the radiocarpal joint for any arthritis before starting the technique , if there was no arthritis , we go on for the procedure . After scaphoid excision , we denuded the articulating surfaces between lunate , capitate , hamate and triquetrum . Then ,any lunate extension deformity was corrected . Then we use k.wires as a fixation method between the above mentioned carpal bones

Also known as: four corner arthrodesis

Four corner fusion

three corner fusion without triquetrum excision PROCEDURE

First , we inspected the radiocarpal joint for any arthritis before starting the technique , if there was no arthritis , we go on for the procedure . After scaphoid excision , we denude the articulating surfaces between lunate , capitate , hamate and don not include triquetrum. Then ,any lunate extension deformity was corrected . Then we use k.wires as a fixation method between the above mentioned carpal bones.

Three corner fusion without triquetrum excision

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• SNAC wrist G II , III

You may not qualify if:

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

Sponsors & Collaborators

• Ain Shams University: lead

Study Sites (1)

Ain Shams University , Faculty of medicine

Al ‘Abbāsīyah, Cairo Governorate, 11655, Egypt

Location

Related Publications (3)

• 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.

  PMID: 19592604 BACKGROUND

• 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.

  PMID: 19258133 BACKGROUND

• 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.

  PMID: 26409577 BACKGROUND

Study Officials

• Mohamed M Elmahy, Professor

  Ain Shams University

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Two groups with the first intervention four corner fusion , and the second with three corner fusion without triquetrum excision

Study Record Dates

• First Submitted: May 2, 2022
• First Posted: May 5, 2022
• Study Start: September 20, 2018
• Primary Completion: October 30, 2021
• Study Completion: December 2, 2021
• Last Updated: May 5, 2022

Record last verified: 2022-05

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)