Capitolunate Arthrodesis: A Systematic Review

Abstract

Purpose: To compile and review the indications, outcomes, and complications of capitolunate arthrodesis (CLA).

Methods: We performed a literature search identifying 33 articles, 6 of which met inclusion criteria, including 80 patients. Included publications contained the results of CLA with minimum 12-month follow-up between 2000 and 2018. Data were pooled and analyzed focusing on the primary outcomes of union and complications.

Results: Average age of patients was 48 years (range, 22-86 years), median follow-up was 34 months (range, 12-198 months), and most common indication was scaphoid nonunion advanced collapse (59%). Nearly half underwent a concomitant triquetrum excision (49%). Most patients were pain-free (78%) and returned to work (92%). Grip strength and visual analog pain scale both improved after CLA. Whereas 96% fused within a reported 42 to 210 days (median, 70 days), 11% of patients had complications including nonunion (3.8%) and loose hardware (6.3%). The reoperation rate was 14%, including wrist arthrodeses and wrist arthroplasty.

Conclusions: Capitolunate arthrodesis is a feasible option for scapholunate advanced collapse and scaphoid nonunion advanced collapse wrists with complications similar to those encountered in 4-corner arthrodesis.

Type of study/level of evidence: Therapeutic IV.

Keywords: 4-corner arthrodesis; capitolunate arthrodesis; scaphoid nonunion advanced collapse; scapholunate advanced collapse.