Wrist arthrodesis using an embedded iliac crest bone graft

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Bone Grafting Techniques

Background:

• Wrist arthrodesis is a surgical procedure to fuse the wrist joint, often indicated for severe arthritis or instability.
• Traditional methods may have limitations in restoring full function and range of motion.
• Iliac crest bone grafts are a common source for bone reconstruction due to their structural integrity and osteogenic potential.

Purpose of the Study:

• To evaluate the efficacy and outcomes of wrist arthrodesis using an embedded iliac crest bone graft technique.
• To assess pain relief, functional recovery (pronation, supination, grip strength), and complication rates associated with this specific surgical approach.

Main Methods:

• A retrospective review of 34 patients undergoing wrist arthrodesis with an embedded iliac crest bone graft.
• Procedure involves a straight ulnar approach, distal radioulnar joint resection, and graft placement in a prepared trench in the radius and carpus.
• Patients were immobilized in a short-arm cast for 2-3 months post-operatively.

Main Results:

• High fusion rate: 32 out of 34 arthrodeses (94%) achieved bony union within 3 months.
• Significant pain relief: 85% of patients reported complete pain relief.
• Functional improvement: Normal pronation and supination restored by 5 months post-operatively; 80% experienced increased grip strength.
• Low complication rate: Including two ulnar nerve lesions and two delayed unions.

Conclusions:

• Embedded iliac crest graft wrist arthrodesis is an effective technique for achieving solid fusion and significant pain relief.
• Resection of the distal radioulnar joint contributes to improved pronation and supination.
• The procedure offers a viable option for wrist reconstruction, preserving or enhancing grip strength with a manageable complication profile.