Total wrist fusion. A functional assessment

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Research

Background:

• Post-traumatic wrist conditions often lead to chronic pain and functional deficits.
• Previous surgical interventions may fail to provide lasting relief, necessitating salvage procedures.
• Total wrist fusion is a reconstructive option for severe wrist pathology.

Purpose of the Study:

• To evaluate the objective, subjective, and radiological outcomes of total wrist fusion.
• To assess patient satisfaction, pain relief, and functional recovery following the procedure.
• To identify the complication rate and its impact on overall results.

Main Methods:

• Retrospective review of twenty patients who underwent total wrist fusion for post-traumatic wrist conditions.
• Objective assessment included functional tests (Jebsen, Purdue).
• Subjective assessment involved patient satisfaction and pain scores. Radiological evaluation assessed fusion, carpal height, and fused joints.

Main Results:

• All patients reported satisfaction with wrist position and experienced good pain relief.
• A high complication rate of 45% was observed, though only four patients required reoperation.
• Hand function, assessed by standardized tests, was poor, potentially linked to reduced finger mobility.

Conclusions:

• Total wrist fusion provides significant pain relief and high patient satisfaction in post-traumatic cases.
• Despite favorable subjective outcomes, objective hand function remains compromised.
• The procedure is associated with a substantial complication rate, necessitating careful patient selection and management.