Complications and results of scapho-trapezio-trapezoid arthrodesis.

Forty cases of scapho-trapezio-trapezoid (STT) arthrodesis were reviewed. Indications for the procedure included rotatory subluxation of the scaphoid (30 patients) and STT arthrosis (ten patients). Follow-up time averaged 41 months. Ten patients (25%) required 13 additional procedures: operations for nonunion or a fracture of the distal radius after bone harvesting, partial radial styloidectomy, first carpometacarpal joint arthroplasty, and wrist arthrodesis. Complications without surgeries were seen in several cases: pin-tract infection, sympathetic dystrophy, delayed union treated with brace, and radial nerve irritation. Overall, complications were observed in 21 patients (53%), some having more than one complication. Degenerative arthritis at joints surrounding the STT mass was suspected based on roentgenograms in five cases. Twenty-three patients (58%) became pain free or had minimal pain with a limited arc of motion. Twenty of 34 patients (59%) returned to their regular work or the same job, and 27 (68%) reported good to excellent results. Although STT arthrodesis can provide a painless wrist with a limited arc of motion in most patients, complications are frequent.