Limited Carpal Arthrodeses for the Treatment of Wrist Osteoarthritis

The five main etiologies of wrist osteoarthritis are: a) Scapholunate instability leading to Scapholunate advanced collapse (SLAC) b) Scaphoid nonunion leading to Scaphoid Nonunion Advanced Collapse (SNAC) c) Distal radius intra-articular malunion d) Kienbock stage IV e) Chondrocalcinosis. The two last diseases are not post-traumatic. We discuss the advancement of arthritis in different stages, and the possibilities of limited carpal arthrodesis to fuse the joints involved in arthritis, taking care to preserve the intact joints. This retains a certain amount of motion at the wrist. It is always better to avoid total wrist arthrodesis which is less and less performed, due to the good long-term results of limited carpal arthrodeses.