None listed
Conditions
Brief summary
The wrist pain in SLAC/SNAC arthritis comes from wear and break down between specific bones in the wrist. By fusing the affected bones, surgeons can improve pain while maintaining some range of motion. To accomplish this, the ulnar-sided (the side of your little finger) bones can be fused (known as four-corner fusion). A second option exists where an extra bone is removed and the remaining bones are fused in the same way as for the four-corner fusion. (This is known as a 2-corner fusion). Surgeons have more commonly performed four-corner fusion for this problem. Two corner fusions have gained popularity and the outcomes of surgery with these two methods are similar. In addition to treating the pain from the arthritic joints, a two-corner fusion may offer improved range of motion compared to the four-corner fusion. This research will provide valuable information towards improving knowledge of SNAC/SLAC arthritis treatment. Currently, it is unknown whether one method is superior to the other. This study will help answer this question and ensure that future patients get the operation that gives them the best function.
Interventions
This is a prospective randomised controlled trial of two-corner fusion versus four-corner fusion for wrist arthritis associated with scapholunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC).
Patients with wrist pain and stiffness refractory to conservative measures, will be randomised to either a two- or four-corner fusion. Four-corner fusion (control gorup) is the routine practice for these conditions: it involves scaphoid excision and fusion of the lunate, capitat
This is a prospective randomised controlled trial of two-corner fusion versus four-corner fusion for wrist arthritis associated with scapholunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC). Patients with wrist pain and stiffness refractory to conservative measures, will be randomised to either a two- or four-corner fusion. Four-corner fusion (control gorup) is the routine practice for these conditions: it involves scaphoid excision and fusion of the lunate, capitate, triquetrum and hamate bones. Two-corner fusion (study group) involves excision of scaphoid and triquetrum bones, and fusion of the luno-capitate joint. Both surgeries will be performed by Orthopaedic surgeons with fellowship sub-specialty training in hand surgery. Duration of surgery is similar for both surgeries, being 60-90 minutes. No additional training is required for 2-corner fusion surgery.
Sponsors
A/Prof Eugene Ek
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients with wrist pain and x-ray findings of SLAC/SNAC who have failed conservative therapy, which includes analgesia, splinting, physio/hand therapy +/- trial of corticosteroid injections
Exclusion criteria
- Pregnant women, - Children and/or young people (<18 years) - People with an intellectual or mental impairment - People highly dependent on medical care
Outcome results
None listed