The Use of Compression Staples for Scaphotrapeziotrapezoid Arthrodesis in the Treatment of Scaphotrapeziotrapezoid Arthritis.

Scaphotrapeziotrapezoid (STT) arthritis is not frequently encountered by hand surgeons and may occur in association with thumb carpometacarpal arthritis or in isolation. The incidence of STT arthritis has been reported at widely varying frequencies and may be addressed using different surgical techniques, depending on other concomitant foci of arthritis. Described treatments for isolated STT arthritis include STT arthrodesis, distal scaphoid excision, interposition arthroplasty, and pyrocarbon arthroplasty, though a consensus regarding the most effective technique is lacking. Early critics of STT arthrodesis note that this technique can be technically demanding and associated with high rates of complication, including nonunion; however, newer data have shown an acceptable complication profile with nonunion rates averaging 6.3%. Fusion of the STT joint has been achieved via the use of Kirshner wires, plates, screws, and staples; however, to our knowledge, no study has described a surgical technique using compression staples as the method of fixation for STT arthrodesis. As such, we present the use of compression staples in our 3-patient case series for the treatment of STT osteoarthritis. All patients achieved complete radiographic union within 4 months and experienced improvement in their radial-sided wrist pain; however, 1 patient subsequently developed central wrist pain secondary to capitolunate arthritis. Range of motion was largely preserved; however, grip strength decreased postoperatively. The average tourniquet time was 69 minutes. In summary, we find the use of compression staples to be a feasible technique for STT arthrodesis in the treatment of STT osteoarthritis.