Total wrist fusion versus total wrist prosthesis: a comparative study.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Reconstructive Surgery

Background:

• Total wrist fusion (TWF) is a common treatment for debilitating wrist conditions.
• Total wrist prostheses offer a joint-sparing alternative for select patient populations.
• Comparative data on medium-term outcomes between TWF and modern prostheses are limited.

Purpose of the Study:

• To compare the medium-term functional outcomes and complication rates of total wrist fusion (TWF) using contoured plates versus total wrist prostheses (Universal 2™).
• To evaluate patient-reported outcomes including grip strength, pain, and functional status in both treatment groups.

Main Methods:

• A comparative study involving 41 patients undergoing TWF with contoured plates and 22 patients receiving Universal 2™ total wrist prostheses.
• Mean follow-up of 6 years for TWF and 6.5 years for prostheses.
• Assessment of grip strength, Visual Analogue Scale (VAS) for pain, Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH), Patient-Rated Wrist Evaluation (PRWE), patient satisfaction, and complication rates.

Main Results:

• No significant differences were observed between TWF and total wrist prostheses in grip strength, VAS pain scores, Quick DASH, or PRWE scores.
• Patient satisfaction levels were comparable between the two treatment groups.
• The incidence of complications did not differ significantly between the TWF and total wrist prosthesis groups.

Conclusions:

• Total wrist prostheses provide medium-term functional results comparable to total wrist fusion in patients with low or moderate functional demands.
• Total wrist prostheses do not appear to increase the complication rate compared to TWF in this patient cohort.
• These findings support the consideration of total wrist prostheses as a viable option for specific patient groups requiring wrist reconstruction.