Radiolunate arthrodesis.

The procedure of radiolunate arthrodesis was suggested by spontaneous radiolunate arthrodesis that resulted in painless, satisfactory function. Ulnar translation down the inclined slope of the radius is accelerated by dorsal dislocation of the ulnar head, ulna minus variance, and triangular fibrocartilage resorption and may be an inducement to increased ulnar deviation of the fingers as well as disintegration of the proximal carpal row. Twenty-two radiolunate arthrodeses were performed, 16 by a corticocancellous slotted graft and six by a modified Lauenstein procedure in 17 rheumatoid and five traumatic cases. Nineteen wrists were available for follow-up at an average of 28 months. Average range of motion was 25 degrees of extension, 30 degrees of flexion, 5 degrees of radial deviation, and 15 degrees of ulnar deviation. Subjective evaluation was good in 14 wrist, fair in three, and poor in two. Relief of pain was generally satisfactory, and preoperative grip strength was slightly improved. Progressive degeneration of the midcarpal joint tends to be minimal. If further spontaneous arthrodesis occurs, the wrist remains in satisfactory position. Carpal ulnar translation, midcarpal angulation, and radial angulation are corrected. Loss of carpal height is partially corrected in most instances.