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Total Wrist Arthrodesis: A Preoperative Test to Predict Functional Outcomes
Bruno Adona Ribeiro1, Yuri Souza Zillig1, Luis Guilherme Rosifini Alves Rezende1
1Cirurgião ortopedista da Divisão de Mão do Departamento de Ortopedia e Anestesiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Revista Brasileira De Ortopedia
|November 1, 2023
Summary
Predicting the success of total wrist arthrodesis (TWA) is possible. Patients responding well to anesthesia before surgery showed improved outcomes after TWA, suggesting a useful assessment protocol.
Area of Science:
- Orthopedics
- Hand Surgery
- Musculoskeletal Research
Background:
- Total wrist arthrodesis (TWA) is a surgical procedure for severe wrist arthritis.
- Predicting functional success and optimizing patient selection for TWA remains a challenge.
- Evaluating pre-operative indicators can guide surgical indications for TWA.
Purpose of the Study:
- To develop and validate an evaluation method for predicting functional success in total wrist arthrodesis.
- To assist in determining appropriate indications for TWA based on pre-operative assessments.
- To correlate pre-operative anesthetic response with post-operative functional outcomes.
Main Methods:
- Prospective study of ten patients undergoing TWA for post-traumatic arthritis.
- Objective (grip strength, pinch strength) and subjective (DASH, PRWE, VAS) functional assessments were performed.
- Assessments were conducted pre-operatively (without and with anesthesia) and 12 weeks post-operatively.
Main Results:
- Significant increases in handgrip and pinch strength were observed after pain relief via anesthesia and post-arthrodesis.
- Patients reported significantly better subjective functional scores (DASH, PRWE, VAS) at 12 weeks post-surgery.
- No statistical difference in strength was found between post-anesthesia and 12-week post-TWA measurements.
Conclusions:
- A pre-operative assessment protocol using intra-articular anesthetic infiltration can predict TWA success.
- Patients showing a positive response to anesthetic blocks are likely to benefit from TWA.
- This method can aid in selecting suitable candidates for total wrist arthrodesis.
