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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(05): e766-e770
DOI: 10.1055/s-0043-1771002
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Total Wrist Arthrodesis: A Preoperative Test to Predict Functional Outcomes

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Bruno Adona Ribeiro
1   Cirurgião ortopedista da Divisão de Mão do Departamento de Ortopedia e Anestesiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Yuri Souza Zillig
1   Cirurgião ortopedista da Divisão de Mão do Departamento de Ortopedia e Anestesiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Luis Guilherme Rosifini Alves Rezende
1   Cirurgião ortopedista da Divisão de Mão do Departamento de Ortopedia e Anestesiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Filipe Jun Shimaoka
1   Cirurgião ortopedista da Divisão de Mão do Departamento de Ortopedia e Anestesiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Luiz Garcia Mandarano-Filho 
1   Cirurgião ortopedista da Divisão de Mão do Departamento de Ortopedia e Anestesiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
,
Nilton Mazzer
1   Cirurgião ortopedista da Divisão de Mão do Departamento de Ortopedia e Anestesiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
› Author Affiliations Financial Support The author(s) received no financial support for the research, authorship, and/or publication of this article.
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Abstract

Objective The study aims to demonstrate an evaluation method to predict the functional success of total wrist arthrodesis (TWA) and assist its indication.

Methods A prospective study including ten patients submitted to (TWA) posttraumatic arthritis. Exclusion criteria were patients who lost postoperative follow-up or incomplete information in the medical record. The objective functional assessment (handgrip strength, three-point pinch, lateral pinch and pulp-pulp pinch) and the subjective functional assessment (DASH, PRWE, EVA) were evaluated in 3 different periods: (1) Before surgery without articular anesthesia, (2) Before surgery under articular anesthesia and (3) 12 weeks after the surgical procedure.

Results There was an increase in handgrip strength in all three pinches measurements after pain relief, both after joint anesthesia and after the consolidation of the arthrodesis (p < 0.05). In the comparisons between the subjective evaluations (DASH, PRWE and VAS), the patients had better scores in the postoperative evaluation after 12 weeks (p < 0.05). There was no statistical difference when comparing the mean strength values found after anesthesia and after 12 weeks of TWA.

Conclusion the outcomes could propose an assessment protocol for patients with indication for TWA, in which patients with good response to intra-articular anesthetic infiltration would benefit from the effects of the surgical procedure.

Keywords

arthrodesis - wrist joint - wrist

Work developed at Department of Orthopaedics, Trauma, and Anesthesiology of the Hospital of Clinics of Ribeirao Preto Medical School of the University of São Paulo, São Paulo, SP, Brazil.




Publication History

Received: 17 May 2022

Accepted: 08 November 2022

Article published online:
30 October 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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