Treatment is directed at the arthritic joint between the scaphoid and radius. The joint between the radius and lunate is consistently not affected with this type of post-traumatic arthritis, which enables a procedure that preserves functional wrist motion, and restores pain-free grip strength.
The 2 main treatment options are PRC (proximal row carpectomy) and midcarpal fusion with scaphoid bone excision. For patients with SLAC arthritis related to a scaphoid nonunion(also called SNAC arthritis), a 3rd option exists--excision of the distal pole of the scaphoid.
Midcarpal fusion with scaphoid excision and PRC result in comparable outcomes. The decision to perform one over the other will revolve around the extent of your arthritis on xray, whether you are a laborer,what other recreational demands you place on your wrist, and whether you have a smoking history, since tobacco use may decrease union rates.
