Proximal Row Carpectomy Versus Four Corner Fusion

Comparison of Subjective, Radiological and Functional Results After Proximal Row Carpectomy and Four Corner Fusion

There are two types of interventions to treat a post-traumatic wrist osteoarthritis: the proximal row carpectomy and the four corner fusion. They are used to reduce pain and to maintain the mobility. In previous studies are shown that the proximal row carpectomy shows a better mobility of the wrist postoperatively, whereas the four corner fusion has lower progression of radiocarpale osteoarthritis.

The purpose of this study is to compare the clinical, radiological and subjective outcomes after the treatment with a proximal row carpectomy or a four corner fusion.

Study Overview

• Status: Completed
• Conditions: Wrist Osteoarthritis
• Intervention / Treatment: Procedure: proximal row carpectomy; Procedure: four corner fusion

Detailed Description

Two surgical procedures are used to treat a post-traumatic wrist osteoarthritis, especially after scaphoid non-union advanced collapse (SNAC) and scapholunate advanced collapse (SLAC): the proximal row carpectomy and the four corner fusion. Both surgical procedures are rescue operations. They are used to reduce pain and to maintain the mobility, compared to a complete stiffening of the wrist.

In previous studies are shown that the proximal row carpectomy shows a better mobility of the wrist postoperatively and a lower complication rate, whereas the four corner fusion has a lower progression of radiocarpale osteoarthritis and a better grip strength.

The purpose of this study is to compare the clinical, radiological and subjective outcomes after the treatment with a proximal row carpectomy or a four corner fusion.

• Study Type: Observational
• Enrollment (Anticipated): 114

Contacts and Locations

Study Locations

• Switzerland
  • Zurich, Switzerland, 8008
    • Schulthess Klinik

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patients with a post-traumatic wrist osteoarthritis, who are treated with a proximal row carpectomy or a four corner fusion

Description

Inclusion Criteria:

• post-traumatic wrist osteoarthritis
• treated with a proximal row carpectomy or four corner fusion
• signed written informed consent

Exclusion Criteria:

• no knowledge of German

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
proximal row carpectomy; patients were treated with a proximal row carpectomy	Procedure: proximal row carpectomy; excision of the scaphoid, lunate and triquetrum
four corner fusion; patients were treated with a four corner fusion	Procedure: four corner fusion; excision of the scaphoid and stiffening of the lunate, capitate and triquetrum by a plate

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Range of motion of the wrist	measurements of flexion/extension,supination/pronation and radial-/ulnarduction of the wrist	participants will be followed up by an expected average of 4.5 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
complication rate	Detection of complications of both surgical procedures	participants will be followed up by an expected average of 4.5 years

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
grip strength	measurement of grip strength	participants will be followed up by an expected average of 4.5 years
Patient-Rated Wirst Evaluation (PRWE)	Comparison of proximal row carpectomy and four corner fusion in respect to PRWE	participants will be followed up by an expected average of 4.5 years
Michigan Hand Outcomes Questionnaire (MHQ)	Comparison of proximal row carpectomy and four corner fusion in respect to MHQ	participants will be followed up by an expected average of 4.5 years
Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH)	Comparison of proximal row carpectomy and four corner fusion in rsespect to QuickDASH	participants will be followed up by an expected average of 4.5 years
Detection of radiological parameters	Detection of arthrosis fossa lunata, impingement and loosening	participants will be followed up by an expected average of 4.5 years

Collaborators and Investigators

• Sponsor: Schulthess Klinik
• Investigators: Principal Investigator: Daniel B Herren, Dr. med., Schulthess Klinik

Study record dates

Study Major Dates

• Study Start: July 1, 2013
• Primary Completion (Actual): January 1, 2014
• Study Completion (Actual): January 1, 2014

Study Registration Dates

• First Submitted: July 11, 2013
• First Submitted That Met QC Criteria: July 18, 2013
• First Posted (Estimate): July 24, 2013

Study Record Updates

• Last Update Posted (Estimate): February 27, 2014
• Last Update Submitted That Met QC Criteria: February 26, 2014
• Last Verified: February 1, 2014

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Arthritis; Osteoarthritis
• Other Study ID Numbers: PRC01