Teil-Arthrodesen von Skaphoid, Trapezium und Trapezoideum (STT-Fusion)

BACKGROUND: Scapho-trapezio-trapezoid (STT)/triscaphe fusion is used to stabilize the radial column of the wrist. However the reported results are controversial. MATERIAL AND METHODS: 111 patients were treated with STT fusion from 1992 to 1997. Indications were chronic dissociation of the scapholunate joint (n = 15), idiopathic arthrosis of the scaphotrapeziotrapezoid joint (n = 11), Kienbock's disease in advanced stage (n = 84) and dislocation of the trapezium (n = 1). This study reviews the results after an average follow-up period of four years (range, two to eight years). RESULTS: Patients showed an average wrist motion (ROM) in extension and flexion of 81 % of the preoperative range and in radial and ulnar deviation of 68 % of the preoperative range. Preoperative pain values (VAS) were reduced 76 % (non-stress) and 55 % (stress). The average grip strength improved to 65 % of the contra-lateral side. Good results were reached according to the modified Mayo wrist score with a score of 66 points (71 points in arthritis of the STT joint; 62 points in Kienbock's disease, 60 points in SL-dissociation). The patients described low disability in the DASH scores, with an average of 27 points. CONCLUSIONS: Our data show that STT fusion is reliable and effective for treatment and pain relief and offers reasonable functional results in the above mentioned indications.