Aims Total wrist arthrodesis (TWA) produces a spectrum of outcomes. We investigated this by reviewing 77 consecutive TWA performed for inflammatory and post-traumatic arthropathies, wrist instability and as a salvage procedure.
Patients and Methods All operations were performed by a single surgeon using a specifically designed pre-contoured dorsally applied non-locking wrist arthrodesis plate at a single centre.
Results Median post-operative Buck-Gramcko Lohman (BGL), Disabilities of the Arm, Shoulder and Hand and Patient Rated Wrist Evaluation scores at six years (interquartile range (IQR) 3 to 11) were 9 (IQR = 6 to 10), 19 (IQR = 7 to 45) and 13 (IQR = 1 to 31) respectively. Polyarticular inflammatory arthritis and female gender were associated with poorer patient-reported outcomes, although the effect of gender was partly explained by higher rates of inflammatory disease among women. Return to work was negatively influenced by workers’ compensation and non-inflammatory wrist pathology. There was no difference in complication rates for inflammatory and non-inflammatory indications.
Take home message: Polyarticular inflammatory arthritis is a risk factor for adverse patient-reported outcomes in TWA. Furthermore, when compared with patients without inflammatory arthritis, dorsally applied pre-contoured plates can be used for wrist arthrodesis in patients with inflammatory arthritis without an increased risk of complications.
Cite this article: Bone Joint J 2016;98-B:647–53.
D. H. Owen: Planning research, Data collection, Writing paper.
P. A. Agius: Statistical analysis, Drafted paper.
A. Nair: Data collection, Drafted paper.
D. M. Perriman: Data collection, Drafted paper.
P. N. Smith: Planning of research, Writing and drafting of paper.
C. J. Roberts: Planning of research, Writing and drafting of paper.
The authors would like to thank C. Blowes for her help in retrieving patient records.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This article was primary edited by G. Scott.
- Received December 19, 2014.
- Accepted January 19, 2016.
- ©2016 The British Editorial Society of Bone & Joint Surgery