Intercarpal arthrodesis in the management of chronic carpal instability after trauma

A retrospective review of five patients with chronic carpal instability resulting from trauma suggests that this condition can be successfully treated by intercarpal arthrodesis. Scaphoidlunate fusion was used to treat chronic dorsal intercalary segment instability, while scaphoidcapitate-lunate fusion was used to treat chronic palmar intercalary segment instability. Results after intercarpal arthrodesis were consistently good, with restoration of painless function, preservation of grip strength, and a high degree of patient satisfaction. Although a fibrous union was obtained in two of the three scaphoid-lunate arthrodeses, this did not prejudice a good clinical outcome. These results compare favorably to those with other treatment modalities, including ligamentous reconstructions with tendons. Based on these findings, a more extensive clinical trial of intercarpal arthrodesis to treat chronic carpal instability appears warranted.