Reliability of the 8 Week Time Point for Single Assessment of Midcarpal Fusion by CT Scan
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High rates of nonunion have recently been reported for midcarpal fusions. Due to curvature and overlap of carpal interfaces, two dimensional films are not reliable in determining union of a midcarpal fusion. Computed tomography is the most reliable radiographic method of evaluating osseous union. Initiating motion as soon as fusion has occurred is a priority with the goal of maximizing final range. Cost control in healthcare makes obtaining serial scans unreasonable. The single optimal time point for a computed tomography scan to determine union of a midcarpal fusion remains to be determined. A prospective protocol selected 8 weeks post operative as the point in time to obtain the single determining scan. Forty-six consecutive midcarpal fusions with scaphoidectomy were retrospectively analyzed for the reliability of this time point. All fusions had achieved union by 8 weeks and only this one scan was clinically necessary to advance the patients on to full range of motion without a splint at that time.
KeywordsMidcarpal Fusion Computed Tomography Scan Nonunion
Declaration of no conflicting interests
All named authors hereby declare that they have no conflicts of interest to disclose.
- 9.Dacho AK, Baumeister S, Germann G (2008) Comparison of proximal row carpectomy and midcarpal arthrodesis for the treatment of scaphoid nonunion advanced collapse (SNAC-wrist) and scapholunate advanced collapse (SLAC-wrist) in stage II. J Plast Reconstr Aesthet Surg 61:1210–1218PubMedCrossRefGoogle Scholar
- 12.Mantovani G, Mathoulin C, Fukushima WY et al (2010) Four corner arthrodesis limited to the centre using a scaphoid one piece graft and a dorsal circular plate. J Hand Surg Eu 35:38–42Google Scholar