Salvage Procedures for Proximal Carpal Row Arthritidies: Proximal Row Carpectomy and Partial Wrist Fusion

ABSTRACT Derangements of the proximal carpal row are a common cause of wrist arthritis. The two most common types, Scaphoid Non-Union Advanced Collapse (SNAC) and Scapholunate Advanced Collapse (SLAC) induce flexion of the distal half of the scaphoid either through a fracture or through an incompetent scapholunate ligament. This, in turn leads to arthritis between the scaphoid and the radial styloid. As a secondary consequence, the lunate goes into extension and creates degenerative change between it and the capitate. At this point, there are salvage treatment strategies short of total wrist arthrodesis or arthroplasty that can provide the patient with excellent long-term functional outcomes.