Lunocapitate versus four-corner fusion in scapholunate or scaphoid nonunion advanced collapse: a randomized controlled trial

J Hand Surg Eur Vol. 2024 May;49(5):601-607. doi: 10.1177/17531934231209872. Epub 2023 Oct 30.

Abstract

This pragmatic randomized controlled trial compared lunocapitate fusion (LCF) and four-corner fusion (4CF) for scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) in 64 patients. The primary outcome was change in grip strength from preoperative to 1 year postoperatively. The secondary outcomes were Disability of the Hand, Arm, and Shoulder score, Patient Rated Wrist Evaluation score, EuroQol-5D-3L, range of motion, key pinch strength and complications 12 months postoperatively. Grip strength improved only to a small extent and there was no difference between the groups. No differences were found in the secondary outcomes. In conclusion, LCF is not inferior to 4CF regarding strength, range of motion or patient-reported outcome measures.Level of evidence: I.

Keywords: 4CF; LCF; SLAC; SNAC; Wrist; four-corner fusion; lunocapitate fusion; osteoarthritis; randomized controlled trial.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Pragmatic Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Arthrodesis* / methods
  • Disability Evaluation
  • Female
  • Fractures, Ununited* / surgery
  • Hand Strength*
  • Humans
  • Lunate Bone / injuries
  • Lunate Bone / surgery
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Range of Motion, Articular*
  • Scaphoid Bone* / injuries
  • Scaphoid Bone* / surgery