Excisional Arthroplasty for Scaphotrapeziotrapezoidal Osteoarthritis

Symptomatic scaphotrapeziotrapezoidal (STT) joint osteoarthritis may occasionally require surgery. In the absence of dorsal midcarpal instability, acceptable results may be obtained by an excisional STT joint arthroplasty. After distal scaphoid resection, however, forces are no longer transmitted along the radial column of the wrist. This often results in slight malrotation of the proximal row into extension. To mitigate this problem, different strategies have been proposed (dorsal midcarpal capsulodesis, palmar radioscaphoid capsulodesis, tendon interposition, or pyrocarbon implant interposition). As compared to STT fusion, excisional arthroplasty is less technically demanding, requires less prolonged immobilization, and has fewer complications.