Surgical Management of Scaphotrapeziotrapezoid Arthritis : Q
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Scaphotrapeziotrapezoid (STT) arthritis is the third most common arthritis affecting the wrist and hand, following only basal joint arthritis and the scapholunate advanced collapse (SLAC) pattern. STT arthritis characteristically presents with radial sided wrist pain and swelling, as well as pain with thumb
and wrist range-of-motion (ROM).

Scaphotrapeziotrapezoid (STT) arthritis occurs commonly with basal joint arthritis, but can also occur in isolation or in conjunction with other patterns of wrist arthritis, such as scapholunate advanced collapse. Surgical options depend on the specific clinical scenario encountered. Isolated STT arthritis was classically managed with arthrodesis, but is now often addressed with distal scaphoid resection (open or arthroscopic), trapeziectomy (partial or complete) and partial trapezoid resection, or implant arthroplasty. Development of postoperative dorsal intercalary segment instability is a notable concern with any of these techniques.

STT arthritis in conjunction with basal joint arthritis can be managed effectively with trapeziectomy and either partial trapezoid excision or distal scaphoid excision. STT arthritis with scapholunate advanced collapse is uncommon, but can be managed with proximal row carpectomy or scaphoidectomy and four-corner fusion. If basal joint arthritis is also present, trapeziectomy can additionally be performed, but grip strength is likely to be substantially diminished.