Arthrodesis of the wrist-complications and their management

This report confirms the concept previously established in the literature tha arthrodesis of the wrist is a technically demanding procedure witha significant incidence of postoperative complications. A series of 31 patients is presented in whom wrist arthrodesis was performed using three separate types of operative techniques, with emphasis on postoperative morbidity and complications. Major complications included: pseudarthrosis (six patients), deep wound infection (one patient), neuroma (one patient), fracture of healed fusion (two patients), and impingement of Steinmann pin on metacarpophalangeal joint (one patient). Minor complications occurred in 13 patients, with transient nerve palsy (four patients) and superficial skin necrosis (five patients) accounting for the majority. A technique is described for treating pseudarthrosis following fusion, which has been used successfully in four patients. In each case, an autogenous bone graft was taken from the ipsilateral proximal ulna, thus obviating the need for a second iliac bone graft.