Wrist arthrodesis using a slab bone graft from the dorsal radius

Arthrodesis is a well-established procedure for the management of wrist deformity, instability, and arthritis resulting from various causes. Several techniques, with or without internal fixation or heterotopic bone grafting, have been described, but no single procedure has gained general acceptance. We present our results using a simple and reliable technique that employs a local bone graft and light internal fixation. From 1987 to 1996, eight consecutive patients with wrist lesions were treated using a modified Gill procedure for arthrodesis. The average age of patients was 62 years and the mean follow-up period was 4 years. A slab corticocancellous bone graft harvested from the dorsal aspect of the distal radius was turned about to cover the fusion mass from the distal radius to the third metacarpal bone. Kirschner wires and tension band wires were used to fix the wrist and compress the bone graft. A long arm cast was applied for 6 weeks, followed by a short arm cast until arthrodesis was achieved. The wrist position was well maintained by the tension band wire alone thereafter. Pain relief, grip strength, and assessment of daily activities were documented. Solid fusion was achieved smoothly in all cases and all patients were satisfied with the results. We recommend this simple and reliable technique for wrist arthrodesis.