Comparison of the therapeutic effect of proximal row carpectomy and midcarpal artherodesis in patients with scaphoid fracture and dislocation

Abstract

Background: Fracture or dislocation of scaphoid are commonly present in carpal tunnel bones, which is associated with complications such as scapholunate advanced collapse (SLAC) or scaphoid nonunion advanced collapse (SNAC) in these patients. The aim of this study was to compare the therapeutic effect of proximal row carpectomy (MCA) and midcarpal artherodesis (PRC) in the patients with SNAC and SLAC in stage 2. Methods: In this cross-sectional study, 30 patients with SNAC (21 patients) and SLAC (9 people) underwent PRC or MCA surgery in years 2015-2016 were included. According to the type of PRC or MCA surgical technique, the patients were divided into two groups, and factors such as the pain severity, range of motion (ROM), and grip strength were investigated at 2, 6, and 12 months intervals after the surgery. Findings: The mean pain severities at 2, 6, and 12 months after surgery were 3.30, 2.50, and 0.75 in the PRC group and 1.85, 1.01 and 0.35 in the MCA group, respectively. There were significant differences between the two groups based on the severity of pain 2 and 6 months after surgery (P < 0.05), but there was no significant difference based on severity of pain 12 months after operation (P = 0.28). There was also no significant difference between the two groups based on the ROM and the grip strength (P > 0.05). Conclusion: Postoperative pain in patients with MCA is less than those with PRC, but there is no difference between the two methods in ROM and grip strength. © 2019 Isfahan University of Medical Sciences(IUMS). All rights reserved.