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Published on: January 24, 2018
Free vascularized fibula transfer for total wrist arthrodesis: A solution for failed wrist arthrodesis after wrist
Daniel Reiser1, Mattias Hedspång1, Marcus Sagerfors1
1Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Södra Grev Rosengatan, 701 85 Örebro, Sweden.
Abstract:
Salvage radiocarpal arthrodesis is an option in the treatment of failed wrist arthroplasty. If bony union is achieved the results can be comparable to primary wrist arthrodesis. Substantial bone loss and decreased vascularity of the bone may be an issue in some cases. The present case report describes the case of a 58-year-old man with posttraumatic wrist arthritis after an intraarticular distal radius fracture. He was treated with a wrist hemiarthroplasty which ultimately failed and was converted to a radiocarpal arthrodesis. After two failed arthrodeses with bone grafting and a dorsal locking plate, we performed a free vascularized fibula transfer which resulted in bony union and a pain-free wrist. Free vascularized fibula transfer may be a salvage option in select cases of failed radiocarpal arthrodesis.

