Open versus Arthroscopic Wrist Partial Fusion: A Comparative Study in Treating Carpal Bone Disorders.

Arthroscopic techniques can be a viable alternative surgical procedure for carpal bone fusion. This study retrospectively compares open and arthroscopic surgeries in treating Kienböck's disease, radiolunate (RL) arthritis, scapholunate advanced collapse (SLAC), and scaphoid nonunion advanced collapse (SNAC). We evaluate their clinical outcomes and surgical complications to assess efficacy and safety.

From October 2015 to November 2023, all patients who underwent scaphocapitate (SC) fusion for Keinbock disease, RL fusion for RL arthritis, and lunocapitate (LC) or four-corner fusion (4CF) for SNAC/SLAC were include. Patients undergoing revision surgery were excluded. Clinical outcomes measured included operation time, fusion rate, fusion time, and range of motion (ROM). ROM was recorded preoperatively, and at three months, six months, and the final follow-up postoperatively. All surgeries were performed by the same surgeon.

A total of 28 patients were included (8 Kienböck's, 7 RL arthritis, 5 SLAC, 8 SNAC), all fused with 2-3 headless compression screws. Arthroscopic surgeries had longer operative times but faster fusion time. RL arthritis had better ROM with open surgery, SLAC showed no difference between two techniques, and SNAC maintained ROM with arthroscopy but decreased with open surgery, especially in wrist flexion. All patients achieved successful fusion except two RL arthritis patients who needed reoperation for nonunion. One SLAC and one SNAC patient required reoperation due to screw penetration and screw loosening respectively.

Arthroscopic techniques may be a promising surgical method. Further larger-scale research is needed to validate these findings.

Keywords: Wrist arthroscopy, Partial wrist fusion, Partial wrist arthrodesis, Limited wrist fusion, Arthroscopic assisted