The individual intercarpal joints between adjacent carpal bones are plane synovial joints linked by interosseous, volar, and dorsal ligaments. They contribute collectively to wrist motion but are individually immobile except for the midcarpal joint. Arthrosis of individual intercarpal joints from SLAC or SNAC wrist produces specific patterns of degeneration that guide the choice of partial carpal fusion.
Partial carpal fusions (four-corner fusion: capitate-hamate-lunate-triquetrum with scaphoid excision; scaphoid-trapezium-trapezoid fusion for SNAC) selectively arthrodese degenerate intercarpal joints while preserving motion at remaining joints.
Progressive intercarpal joint degeneration in the radial column from scapholunate instability managed with four-corner fusion and scaphoid excision.
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