Wrist arthrodesis for traumatic conditions: a study of plate and local bone graft application

This study demonstrates the ability to obtain a predictable and complete wrist arthrodesis using local bone graft and a dorsal plate. The donor site morbidity often seen in using iliac crest graft is eliminated with this method. We examined the use of local distal radius bone grafting alone with dorsal plate fixation and its ability to provide a predictable fusion. Twenty-eight consecutive patients underwent wrist arthrodesis by a standard plate fixation technique. Average patient age was 34 years with an average period of symptom duration of 2.1 years. The cohort had undergone 17 previous wrist surgical procedures prior to wrist arthrodesis. The average followup examination period was 2 years. Grip strength, x-ray films, and range of motion were evaluated. All patients had a solid wrist arthrodesis at final follow-up examination. Grip strength, pronation/supination, and digital motion did not change significantly from the preoperative status. No patients complained of wrist pain or instability. Complications included extensor tendinitis at the distal aspect of the plate in four patients requiring plate removal, carpal tunnel syndrome requiring decompression, and distal radioulnar joint pain requiring intra-articular injection of corticosteroid.