Overview
How does the pathophysiology of wrist arthropathy differ from other joint arthropathies?
What causes wrist arthropathy?
What is the pathogenesis of wrist arthropathy?
What is the prevalence of wrist arthropathy?
What is the role of wrist arthrodesis in the treatment of wrist arthropathy?
When is arthrodesis indicated in the treatment of wrist arthropathy?
When is radiocarpal arthrodesis indicated in the treatment of wrist arthropathy?
When is midcarpal fusion indicated in the treatment of wrist arthropathy?
When is limited arthrodesis indicated in the treatment of wrist arthropathy?
What are the contraindications for wrist arthrodesis?
Which alternative treatments may allow wrist arthrodesis to be postponed or avoided?
What is the basis for surgical technique in wrist arthrodesis?
What are the reported outcomes of wrist arthrodesis?
Which factors increase the likelihood of positive results following wrist arthrodesis?
Periprocedural Care
Which clinical history findings are characteristic of wrist arthropathy?
What should be assessed in the preoperative evaluation of patients undergoing wrist arthrodesis?
Which physical findings are characteristic of wrist arthropathy?
What lab tests are included in the preoperative assessment for wrist arthrodesis?
What is the role of radiography in the preoperative assessment of wrist arthrodesis?
What is the role of CT scanning in the preoperative assessment of wrist arthrodesis?
What is included in patient preparation for wrist arthrodesis?
How are patients monitored following wrist arthrodesis?
Technique
What is the role of nonsurgical treatment for wrist arthropathy?
What is the role of surgery for wrist arthropathy?
How is wrist arthrodesis performed?
Which joints are fused in total wrist arthrodesis?
How does the performance of subtotal wrist arthrodesis differ from total wrist arthrodesis?
What is included in postoperative care following wrist arthrodesis?
What are the possible complications of total wrist arthrodesis?
What are the possible complications of wrist arthrodesis related to plate use?
What are the possible complications of arthrodesis related to wrist fusion?
-
Wrist arthrodesis. Lateral wrist radiograph depicting marked wear in radiocarpal articulation.
-
Wrist arthrodesis. Posteroanterior wrist radiograph demonstrating marked radiolunate degenerative joint disease. Either radioscapholunate fusion or total wrist fusion is appropriate treatment.
-
Wrist arthrodesis. Stage III scapholunate advanced collapse (SLAC) wrist. Patient desired motion-preserving procedure.
-
Wrist arthrodesis. Sequence of degenerative changes in scapholunate advanced collapse (SLAC) wrist arthritis pattern.
-
Wrist arthrodesis. Radiograph of patient after wrist fusion. No distal ulnar resection was necessary in this case.
-
Wrist arthrodesis. Lateral view following wrist fusion demonstrating dorsiflexion provided by plate.
-
Wrist arthrodesis. Intraoperative view after plate application. Portions of distal radius and dorsal capitate have been resected to allow proper plate fitting.
-
Wrist arthrodesis. Retinaculum split and repaired to avoid tendon attrition by plate and prevent bow-stringing.
-
Wrist arthrodesis. Posteroanterior radiograph of wrist following scaphoid excision and four-corner (lunate-capitate-hamate-triquetrum) fusion.
-
Wrist arthrodesis. Lateral radiograph of four-corner arthrodesis.
-
Wrist arthrodesis. Note well-preserved joint interval in radiolunate articulation, as well as dorsal translation of the capitate, which must be corrected during fusion.
-
Wrist arthrodesis. Schematic emphasizing need for correct capitolunate alignment during four-corner arthrodesis.
-
Wrist arthrodesis. Completed radioscapholunate fusion.
-
Wrist arthrodesis. Radioscapholunate fusion technique.
-
Wrist arthrodesis. Position of dowel grafts for scaphotrapeziotrapezoidal (STT) fusion (radial) and four-corner fusion (ulnar).
-
Wrist arthrodesis. Side-to-side range of motion after scaphotrapeziotrapezoidal (STT) fusion.