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Arthroscopic-Assisted Partial Wrist Arthrodesis.

Eva-Maria Baur1

  • 1Practice for Plastic and Hand Surgery, James-Loeb-Str. 13, Murnau D-82418, Germany.

Hand Clinics
|October 10, 2017
PubMed
Summary
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Partial wrist arthrodesis (PWA) offers solutions for wrist conditions. Arthroscopic PWAs showed satisfactory healing after revision surgery, highlighting effective techniques for complex cases.

Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Surgical Techniques

Background:

  • Partial wrist arthrodesis (PWA) is a standard procedure for degenerative and posttraumatic wrist conditions.
  • Four-corner fusion (4CF) is commonly indicated for scapholunate advanced collapse and scaphoid nonunion advanced collapse.
  • Various PWA techniques exist, including 4CF, 2-corner, 3-corner, scaphoid-capitate/scaphoid-capitate-lunate, scaphoid-trapezium-trapezoid arthrodeses, and radioscapholunate arthroscopic PWAs (A-PWAs).

Purpose of the Study:

  • To discuss surgical techniques and error avoidance in partial wrist arthrodesis.
  • To compare open versus arthroscopic techniques for PWA.
  • To evaluate the efficacy of screws versus Kirschner wires in PWA.

Main Methods:

  • The author performed 39 wrist arthrodesis procedures, encompassing diverse techniques.
Keywords:
Arthroscopic assistedLimited wrist fusionPartial wrist arthrodesisPartial wrist fusionSLACSNACWrist arthroscopy

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  • Included were 8 revision cases, with 4 involving partial nonunions.
  • Radioscapholunate arthroscopic PWAs (A-PWAs) were specifically performed and analyzed.

    • Main Results:

    • All radioscapholunate arthroscopic PWAs (A-PWAs) achieved satisfactory healing post-revision surgery.
    • The study involved a range of PWA procedures, indicating broad applicability.
    • Revision surgery was necessary for 8 cases, suggesting potential challenges in complex wrist conditions.

    Conclusions:

    • Arthroscopic partial wrist arthrodesis (A-PWA) can be a successful treatment, even after revision.
    • Careful surgical technique and understanding of open versus arthroscopic approaches are crucial for optimal outcomes.
    • The choice between screws and Kirschner wires warrants consideration based on the specific PWA technique and patient factors.