Arthrodesis
Wrist
Indications
- Provides painless & stable wrist once fusion has taken place
- indicated for marked flexion deformity of wrist & fingers, carpal dislocation or painful wrist associated with multiple ruptures of extensor tendons
-
If both wrists are diseased
- arthrodesis of one wrist & arthroplasty of other
-
If not arthroplasty should fix one wrist in flexion & other in extension to enable perineal care (ADL)
Position
Surgical Technique
- Make dorsal longitudinal incision over 4th extensor compartment
- Retract extensor tendons & open radio-carpal joint & intercarpal articulations
- Denude articular surfaces of joints to be arthrodeses
- Fashion DC plate to fit over distal radius onto carpus & base of 3rd metacarpal
- Dig trough from distal radius in straight line towards proximal end of 3rd metacarpal & obtain suitable graft from iliac crest for instertion into trough
- Stabilise plate & suture extensor retinaculum over plate & under extensor tendons
- Close wound
- apply BE POP which should remain in place for 6 weeks
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