[Our method of arthrodesis of the wrist]

The authors emphasize the importance of a stable pain-free carpus for the function of fingers. Reflections on their own type of osteosynthesis are based on anatomical and biomechanical findings. They emphasize the functional concept of the central pillar of the wrist where maximum flexion and extension takes place. In this very line formed by the distal portion of the radius, os lunatum, os capitatum and the base of the third metacarpal bone they apply the splint. The splint is as compared with classical AO splints low (only 2.8 mm), L-shaped and in its cross section slightly convex dorsally. It follows thus the natural arching of the carpal and metacarpal bone and does not increase the tension of soft structures and the overlying skin. By the localization of oval openings it makes slight self-compression possible and ensures adequate, three-point fixation of the metacarpal region. The oval opening in the short branch of the splint serves location of the centre of the transverse section of the second metacarpal bone and ensures correct placement of the screw. It makes plastic operation of extensors possible which in rheumatic synovialis and destruction of the carpal bone are frequently impaired. The authors present the results of 21 operations. Adequate healing of bone was achieved in all patients, on average after 3.5 months. In all the height of the carpal index (CHI) was increased and the hand grip improved. In nine patients they found rupture of the extensors and repaired it. In all instances they performed synovectomy and resection of the head of the ulna. Two patients have bilateral arthrodesis.(ABSTRACT TRUNCATED AT 250 WORDS)