A procedure developed at Mount Sinai Roosevelt’s CV Starr Hand Surgery Center has proven to be a highly successful, long-term treatment for chronic, degenerative arthritis of the wrist. The results of a 20-year study on the effectiveness of the procedure, distal scaphoid resection, were published as the lead article in the September 2014 issue of the Journal of Hand Surgery.
Louis Catalano III, MD, Attending Surgeon at Mount Sinai Roosevelt’s CV Starr Hand Surgery Center, and Assistant Clinical Professor of Orthopaedic Surgery at Icahn School of Medicine at Mount Sinai, led the study. He and his team compared the long-term results of distal scaphoid resection to alternative options in patients with scaphoid fractures. The scaphoid, the most commonly broken bone in the wrist, is located at the base of the thumb.
“Patients with this condition suffer progressive, activity-related pain as well as flexibility and motion loss,” says Dr. Catalano. “The 19 patients we followed in our 20-year study had previously been treated with alternative options that failed, such as splinting and steroid injections.”
The study found that distal scaphoid resection produced favorable, long-term clinical outcomes, including decreased pain, increased grip strength, and improved range of motion. In addition, standard wrist fusion was not required. Only two patients in the study required more conventional reconstructive procedures, including wrist arthrodesis and proximal row carpectomy.
“It is far easier for patients to tolerate distal scaphoid resection than other procedures to treat wrist arthritis, such as bone fusion, which actually limits motion even further,” says Dr. Catalano. “If I were a patient, I would choose to have this simpler procedure done.”
During the scaphoid resection, the surgeon creates a five-centimeter incision over the wrist and carefully removes the broken scaphoid before closing the joint capsule and then the incision with absorbable sutures.
Says Michael Bronson, MD, Chair of Orthopaedic Surgery, Mount Sinai Roosevelt, “Hand fellows come from all over the country to train at the CV Starr Hand Surgery Center. We are fortunate that Dr. Catalano serves as Program Director for our orthopaedic residents. He is a model surgeon-educator-researcher.”