A Modified Surgical Technique for Minimally Invasive Arthroscopic Total Wrist Fusion

Abstract

Background Arthroscopic total wrist arthrodesis is a procedure with minimal violation of extensor compartments and less scar formation, compared with open wrist arthrodesis. In this paper, we would like to present our experience with a modified surgical technique for arthroscopic total wrist arthrodesis.

Description of Technique After an arthroscopic cartilage removal through radiocarpal and midcarpal portals, the operation is continued under fluoroscopic control. In this technique, four wires are inserted separately in four various directions (as described in the paper), followed by insertion of self-tapping cannulated screw, under fluoroscopic control.

Patients and Methods In this prospective study, a total of four patients underwent arthroscopic total wrist arthrodesis using our surgical technique within a period of 2 years. All four patients were followed for a minimum of 3 months for possible complications and functional outcome.

Results The results were satisfactory, and no complication was observed. All the patients had complete union after 12 weeks, and the fusion was radiographically complete in all cases by 12 weeks. All patients were happy with their functional outcomes.

Conclusion Using the described modified arthroscopic technique, we did four total wrist arthrodeses with minimal scar, no complication and acceptable functional results.

Keywords

wrist - arthrodesis - arthroscopy

Authors' Contributions

All authors have contributed equally in all parts of this research.

Note

This study was conducted in Mehr General Hospital, Tehran, Iran.

• References

• 1 Steindler A. Orthopaedic reconstruction work on hand and forearm. New York Med J 1918; 108: 1117-1119
• 2 Wagner ER, Elhassan BT, Kakar S. Long-term functional outcomes after bilateral total wrist arthrodesis. J Hand Surg Am 2015; 40 (02) 224-228
• 3 Wei DH, Feldon P. Total wrist arthrodesis: indications and clinical outcomes. J Am Acad Orthop Surg 2017; 25 (01) 3-11
• 4 Addosooki A, Doi K, Hattori Y, Wahegaonkar A. Wrist arthrodesis after double free-muscle transfer in traumatic total brachial plexus palsy. Tech Hand Up Extrem Surg 2007; 11 (01) 29-36
• 5 Koman LA, Gelberman RH, Toby EB, Poehling GG. Cerebral palsy. management of the upper extremity. Clin Orthop Relat Res 1990; (253) 62-74
• 6 Terzis JK, Barmpitsioti A. Wrist fusion in posttraumatic brachial plexus palsy. Plast Reconstr Surg 2009; 124 (06) 2027-2039
• 7 Hastings II H, Weiss AP, Quenzer D, Wiedeman GP, Hanington KR, Strickland JW. Arthrodesis of the wrist for post-traumatic disorders. J Bone Joint Surg Am 1996; 78 (06) 897-902
• 8 Rizzo M, Ackerman DB, Rodrigues RL, Beckenbaugh RD. Wrist arthrodesis as a salvage procedure for failed implant arthroplasty. J Hand Surg Eur Vol 2011; 36 (01) 29-33
• 9 Nelson DL. Functional wrist motion. Hand Clin 1997; 13 (01) 83-92