Randomized Trial Comparing Partial Wrist Fusion Techniques with and without Triquetral Bone Removal in Adults with Wrist Arthritis

What this Trial Is About

Researchers are evaluating different partial wrist fusion techniques for adults with post-traumatic wrist arthritis, specifically those with stage II or III scapholunate advanced collapse SLAC or scaphoid nonunion advanced collapse SNAC. This randomized clinical trial compares two surgical methods to determine which provides better clinical and radiographic outcomes. The study is designed as a multi-center, double-blind, prospective trial to guide surgical decisions for patients needing wrist fusion surgery. Participants will be randomly assigned to one of two groups Group A will undergo four-corner arthrodesis, where the scaphoid is removed and the lunate, capitate, triquetrum, and hamate bones are fused. Group B will have partial wrist arthrodesis with triquetral excision, where both the scaphoid and triquetrum are removed and either three-corner or capitolunate fusion is performed. The study includes pre-operative assessment and follow-ups at 6 weeks, 3, 6, and 12 months post-surgery. During the study, participants will complete grip strength tests, wrist range of motion measurements, and various questionnaires assessing pain and wrist function at multiple points. Radiographs and complication tracking will also be done at each visit. The primary outcome is grip strength compared between groups over 12 months. Analysis will consider age and sex, using statistical modeling to compare results, aiming to inform which surgical technique best preserves wrist function and patient-reported outcomes.

Randomized Comparison of PARtial Wrist Fusion With or Without Triquetral Excision (PARTE)