Total Wrist Arthroplasty for Posttraumatic Arthritis with Radius Deformity

Newer implant designs and expanding experience have led to a gradual increase in the use of total wrist arthroplasty (TWA) for the treatment of posttraumatic arthritis. New challenges, however, may be encountered with this application, including bony deformities, previous or existing hardware, osteonecrosis, soft tissue injuries, and severe joint stiffness. Because the goals-to relieve pain and provide a functional range of motion-are the same as for more common TWA indications, these technical challenges, along with often higher patient expectations, are important considerations. This article presents possible solutions to these unique surgical challenges, including important preoperative planning to mitigate risks, and the expected outcomes in these patients.