Open and closed arthrodesis of the rheumatoid wrist using a modified (Stanley) Steinmann pin

In a series of 21 patients (22 wrists) with rheumatoid arthritis, arthrodesis of the wrist was done using a modified Steinmann pin (Stanley) either by an open or closed technique. The open technique, which included fragmenting the carpal bones (12 cases), was mainly used when additional procedures were needed simultaneously. The closed technique simply required insertion of the Stanley pin under fluoroscan control through a small incision over the metacarpal head. Nine out of 12 wrists treated with the open technique and nine out of ten of those treated by the closed technique were successfully fused. Complications were few. A single patient was dissatisfied due to continuing pain. Two out of the four pins that migrated (both involving the open technique) have been removed.