Long-term results after total wrist fusion

Area of Science:

• Orthopedic Surgery
• Hand and Wrist Surgery

Background:

• Total wrist fusion is a common surgical procedure for end-stage wrist arthritis.
• Long-term outcomes and patient satisfaction require further investigation.

Purpose of the Study:

• To evaluate the long-term functional results of total wrist fusion.
• To identify factors contributing to persistent pain after surgery.

Main Methods:

• Retrospective review of 71 total wrist fusions in 68 patients.
• Mean follow-up of 11.7 years.
• Assessment using DASH, VAS, modified Mayo wrist score, and patient satisfaction surveys.

Main Results:

• High fusion rate (98.6%) with one asymptomatic non-union.
• Average DASH score of 30 points, indicating favorable long-term function.
• 15% of patients were pain-free; remaining patients reported pain during strenuous activity (VAS 4/10).
• Patients with ≥2 prior operations had worse outcomes on modified Mayo wrist score and PRWE-G.
• Despite pain and motion loss, 93% of patients were highly satisfied.

Conclusions:

• Total wrist fusion achieves good long-term functional results and high patient satisfaction.
• Previous surgical history negatively impacts outcomes.
• Persistent pain during vigorous activity is common but does not significantly diminish overall satisfaction.