Surgical Management of Septic Arthritis of the Wrist: An Analysis of Short- and Long-Term Functional and Clinical...

Septic arthritis of the wrist is a rare but severe condition requiring urgent diagnosis and treatment to prevent joint destruction and functional impairment. The objective of this study was to investigate prognostic parameters and the long-term functional outcomes. This retrospective and prospective cohort study included 44 patients treated for septic arthritis of the wrist between 2008 and 2024. All patients underwent surgical wrist arthrotomy due to concomitant soft tissue involvement, with a median follow-up of 29 months. Clinical outcomes were assessed through total active range of motion (TROM), grip strength, and patient-reported hand function using the DASH questionnaire. Data analysis examined correlations between comorbidities, surgical interventions and long-term outcomes. Staphylococcus aureus was identified in 61.4% of cases, thus being the most common pathogen. Type 2 diabetes mellitus was identified as a risk factor for requiring a higher number of surgeries to control the infection. Patients requiring more invasive procedures showed worse long-term outcomes, with lower grip strength, a limited active range of motion (TROM) and higher DASH scores. Mortality was associated with higher inflammatory markers and older age at the onset of disease. A total of 36.4% of patients were unable to return to work after treatment, while those who successfully returned to work experienced a median recovery period of seven months. The timely initiation of appropriate surgical therapy is essential in the treatment of septic arthritis of the wrist in order to reduce joint damage and associated loss of hand function, particularly in patients with comorbidities such as diabetes mellitus. Studies should focus on comparing different treatment options and developing more targeted rehabilitation strategies to improve functional outcomes.