Radioscapholunate Fusion in Kienböck’s Disease

Radioscapholunate (RSL) fusion is a partial wrist fusion for patients with localized arthritis of the wrist, such as those with Kienbock’s disease. An essential prerequisite is a well-preserved midcarpal joint, which can be confirmed on imaging, arthroscopy or intra-operatively. Cadaveric and clinical studies of RSL fusions demonstrate that excision of the distal scaphoid improves motion of a RSL fusion and has a better union rate. Other studies have also included excision of the triquetrum, demonstrating an increase in the radioulnar arc. There are a variety of fixation options, such as K-wires, staples, and plate fixation.