Scaphocapitolunate arthrodesis.

Since 1985 scaphocapitolunate arthrodesis has been performed on 21 patients with either chronic incompetence of the scapholunate ligament or a scaphoid nonunion. The average age was 31 years; follow-up averaged 28 months. Eighty-six percent of the injuries involved workers' compensation. The operative procedure was done through a dorsal approach, with the use of autogenous bone grafting and Kirschner wire fixation. Eight-one percent healed after the primary procedure; one patient had a major infection. Range of motion averaged 35 degrees of extension, 30 degrees of flexion, 10 degrees of radial deviation, and 20 degrees of ulnar deviation. Grip strength averaged 70% of the uninvolved side. Pain was significantly reduced in 80% of the patients. Sixteen of 20 patients were able to return to work. Radiographic examination at final follow-up showed mild degenerative changes at the radiocarpal joint in two patients.