Partial Wrist Fusion Info Evidence Consent
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
Why this operation has been suggested
Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, starts with the least invasive options that suit your condition. Patients are generally referred to our clinic by their GP; if a physiotherapist has suggested you see us, you will still need a referral from your GP in order to be eligible for the Medicare rebate. A clinic assessment establishes your diagnosis. For long-standing wear-and-tear, we usually try activity changes, therapy, splinting, or injections first. Surgery is considered when these have not given enough improvement.
We suggest this procedure to stabilise your wrist and relieve pain when arthritis or instability has not responded to conservative care. The operation fuses specific wrist bones to create a solid, pain-free joint. This approach preserves more natural movement than a full wrist fusion. Evidence shows that this method provides reliable, resilient functional results that remain stable over time. It also achieves a 100% union rate in appropriately selected patients with a preserved midcarpal joint.
Before the operation
Please fast for seven hours before your surgery. We ask for this specific window so your procedure can start earlier if the list runs ahead. Arrange for someone to drive you home and stay with you afterwards. Wear loose, comfortable clothing to make changing easy. Bring a current list of all medications and supplements you take. Your surgeon will provide specific instructions on which medicines to pause before the day of surgery. We will review your imaging, such as X-rays or scans, to plan the operation carefully. If you have other medical conditions, you may need blood tests or a review with the anaesthetist. Most patients do not require these extra steps.
On the day
You present to the hospital’s surgical admissions unit, where you are checked in and prepared for theatre. You meet the anaesthetist, who reviews your health and answers any final questions. This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief — the anaesthetist decides on the day based on your individual circumstances.
You are then taken into the operating theatre, where the operation is performed. Once it is finished, you wake up in the recovery area, where nurses monitor you while the anaesthetic wears off. They check your pain levels and ensure you are stable. Once you are stable you either go to the ward or go home, depending on the procedure and your recovery. You will receive clear instructions from our team on what to expect next.
What the operation involves
Your surgeon makes a single cut along the back of your wrist. This open approach gives clear access to the joint surfaces that need treatment. Through this opening, your surgeon removes the worn or damaged bone. In some cases, this means taking out the scaphoid bone or reshaping the capitate bone to relieve pressure and pain.
Once the damaged areas are prepared, your surgeon joins the remaining healthy bones together. This process, called fusion, stops the painful grinding motion. To hold the bones steady while they heal, your surgeon uses screws and may add a small plate on top. These devices keep the bones aligned in the correct position. In some specific cases, your surgeon might use a special implant or bone graft to help the fusion succeed.
The cut is closed with stitches (sutures). Your surgeon does not use staples or skin glue for this procedure. A dressing is applied to protect the wound as you begin your recovery.
After the operation
You will wake up in the recovery ward with your arm in a splint or cast to protect the wrist. Pain is managed with medication prescribed by your surgeon. Keep the dressing clean and dry. Most patients stay one night in hospital after this operation, though some are able to go home the same day. Please ensure someone stays with you for the first 24 hours to help you. Your arm must remain elevated to reduce swelling. Do not drive while wearing a cast or splint. You may only drive once the cast is removed and your surgeon clears you. See our guide on driving after upper-limb surgery for more details. We will review your healing at your follow-up appointments.
Recovery
You can expect some swelling and discomfort in the first few days. This is normal as your body heals. We keep you comfortable with pain relief and advise you to keep your hand elevated above your heart level. This helps reduce the swelling and eases the ache. You will wear a splint or cast to protect the wrist while it settles.
Your rehabilitation is guided by hand therapy, not physiotherapy. You will work with Ruby Doolan at Extend Rehabilitation. Ruby is a hand therapist who directs your exercises and makes any splint you need. She helps you regain movement and strength safely. We do not use hinged braces or abduction pillows for this surgery. Your limb is supported only in the splint or cast described for your procedure.
You will start gentle finger movements soon to prevent stiffness. As the swelling settles and movement returns, you will gradually increase your activity. You cannot drive while wearing a cast or splint. You may drive once the cast is removed and your surgeon clears you. For more details, see our guide on driving after upper-limb surgery.
Your timeline may differ from others. Your surgeon and hand therapist will guide you based on how your wrist responds. We focus on reliable, resilient results that remain stable over time. You will return to daily activities as your grip and motion improve.
What can go wrong
Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.
Joint stiffness or reduced movement You might notice your wrist feels tight or does not bend as far as you hoped. This is common as the bones heal and scar tissue forms. Gentle movement exercises help. Tell us if your range of motion feels significantly restricted during your follow-up visits.
Pain that does not settle Some aching is normal while the wrist heals. However, if you feel a deep, throbbing pain that does not ease with simple painkillers, or if pain suddenly worsens, this needs attention. It could signal an issue with the healing bones or the implants. Call the clinic to report persistent or new pain.
Nonunion (bones not fusing) Sometimes the bones do not join together solidly. You might feel a clicking or grinding sensation in your wrist when you try to move it. This can cause ongoing discomfort. If you notice this instability, bring it up at your next review so we can check the healing with an X-ray.
Implant issues If you have a capitate resurfacing implant, it may wear down or break over time. You might feel increased pain or a change in how your wrist moves. In some cases, the implant may need to be removed or replaced with a full wrist fusion. Report any sudden changes in wrist function or new pain near the implant site.
Conversion to full fusion In some cases, the partial fusion may not provide enough stability or pain relief. You might find that your wrist still hurts significantly or feels weak during daily tasks. If this happens, your surgeon may discuss converting to a total wrist fusion. This is a known option if the partial procedure does not meet your needs.
Complications from bone graft or screws If bone graft or screws are used, there is a small risk they may not hold the bones in place correctly. You might feel unusual pressure or pain at the site. If you suspect the fixation is loose, contact us immediately. We will assess whether further treatment is needed.
The complications table on this page lists typical rates if you want the specifics.
When to call us
Call us if you have a fever, increasing wound redness or discharge, or sudden severe pain. Go to emergency if you notice calf swelling or shortness of breath. Seek urgent care for loss of sensation or inability to move your limb. We are here to help if you are worried about your recovery.
Where to read more
This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Wrist Osteoarthritis page.
Where to read more
This page is about the operation itself. The condition it treats — including what the evidence shows about when surgery helps and when it does not — is covered in more detail on the Wrist Osteoarthritis page.
Evidence & references
This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.
Overview
- Total wrist fusion should only be used in exceptional circumstances [1].
- Total wrist fusion should only be used for exceptional circumstances [2].
- Radioscapholunate (RSL) fusion is a palliative procedure that preserves some of the wrist's mobility but has a significant nonunion rate [4].
- Nonspanning arthrodesis is an alternative method for total wrist fusion with a high union rate and minimal risk of complications at the carpometacarpal joint [5].
- Total wrist arthroplasty and partial wrist arthroplasty have a noteworthy potential for complications requiring additional surgery [6].
- Total wrist arthrodesis provides reliable pain relief and good functional outcomes with high patient satisfaction, particularly for end-stage arthritis and as a salvage technique [7].
- Additional studies are required to confirm findings regarding partial wrist denervation and investigate who may benefit from it [8].
- There is a low rate of conversion to total wrist arthrodesis following scaphoid excision and four-corner arthrodesis for advanced carpal collapse [9].
- Proximal row carpectomy using decellularized dermal allograft expands the indications for PRC to include select patients with degeneration of the capitate head [16].
- Total wrist arthroplasty and total wrist arthrodesis are both extremely cost-effective procedures in rheumatoid arthritis [22].
- Limited wrist arthrodesis techniques are reliable and effective for a wide range of wrist disorders, with low complication rates and high patient satisfaction [45].
Anatomy & Pathophysiology
- Total wrist fusion is reserved for exceptional circumstances [1].
- Wrist arthrodesis predictably relieves pain and provides a stable wrist for power grip [39].
- Despite loss of wrist motion, most patients report satisfactory functional outcomes and can accomplish most daily activities with adaptation and compensation [11].
- The lateral approach to wrist arthrodesis preserves the distal radio-ulnar joint, avoids scarring of the extensor mechanism, and maintains normal wrist appearance [26].
- Radialization or lateralization of a translocated ulna, aligned with the second metacarpal, decreases reduction in wrist circumference and reduces wrist narrowing [27].
- Radiolunate arthrodesis is effective for unstable wrists with preserved midcarpal joint space [43].
- The choice of procedure for the rheumatoid wrist depends on the pattern of wrist destruction and stability [43].
- The MIRLIN procedure addresses critical stabilizers to prevent carpal instability and collapse [37].
- Proximal row carpectomy (PRC) provides satisfactory postoperative wrist range of motion and grip strength with few complications, particularly in the absence of capitolunate arthrosis [24].
- PRC provides good pain relief with preservation of wrist motion [17].
- PRC individuals demonstrate improved performance and greater wrist motion compared to midcarpal arthrodesis (MA) during hammering [30].
- PRC provides improved flexion-extension with a circumduction curve concentric with the nonsurgical wrist [31].
- Most tasks are performed significantly quicker by patients after PRC compared to four-corner fusion [35].
- PRC has improved motion and fewer complications in patients younger than age 45 years [40].
- Four-corner arthrodesis (4CF) outcomes show significant differences in range of motion and grip strength depending on osteosynthesis methods, but these differences are unlikely to be clinically relevant [28].
- Wrist motion following 4CF correlates positively with preoperative motion, although most patients do not differ significantly in postoperative motion [38].
- Arthrodesis of the reconstructed radiocarpal joint provides better grip strength and functional outcomes than arthroplasty following giant cell tumor excision of the distal radius [41].
Classification
- Radiolunate fusion provides good and excellent clinical results in the majority of patients, and these outcomes do not depend on the fixation device [3].
- Radioscapholunate (RSL) fusion is a palliative procedure that preserves some wrist mobility but has a significant nonunion rate [4].
- Nonspanning arthrodesis is an alternative method for total wrist fusion that offers a high union rate and minimal risk of complications at the carpometacarpal joint [5].
- Four-corner arthrodesis (scaphoid excision) has a low rate of conversion to total wrist arthrodesis [9].
- Proximal row carpectomy (PRC) and four-corner arthrodesis (FCA) demonstrate similarly low rates of conversion to total wrist arthrodesis [10].
- Primary wrist arthrodesis results are slightly more favorable than those for salvage of failed total wrist arthroplasty via total wrist arthrodesis [12].
- Complications and reoperations following total wrist arthrodesis occur frequently, most often due to incomplete bone fusion or hardware-related problems [14].
- It remains unknown which implant type is best for total wrist arthrodesis or if the carpometacarpal joint should be included [14].
- Total wrist arthrodesis combined with proximal row carpectomy (PRC) provides reliable and reproducible benefits in the rheumatoid wrist [15].
- Newer fourth-generation wrist implants appear to perform better than earlier designs [19].
- Proximal row carpectomy is a motion-preserving salvage procedure with a low rate of conversion to wrist arthrodesis [21].
- Four-corner arthrodesis using headless compression screws yields results comparable to or better than previously published techniques regarding fusion rates, pain alleviation, grip strength, range of motion, Mayo wrist score, and Disabilities of the Arm, Shoulder, and Hand questionnaire score [44].
Clinical Presentation
- Radiolunate fusion yields good and excellent clinical results in the majority of patients, independent of the fixation device used [3].
- Nonspanning arthrodesis is an alternative method for total wrist fusion characterized by a high union rate and minimal risk of complications at the carpometacarpal joint [5].
- Total wrist arthroplasty (TWA) and partial wrist arthroplasty carry a noteworthy potential for complications requiring additional surgery [6].
- Additional studies are required to confirm findings regarding partial wrist denervation and to investigate which patients may benefit from it [8].
- Most patients report satisfactory functional outcomes after wrist arthrodesis despite loss of motion, confirming the ability to accomplish most daily activities with adaptation and compensation [11].
- Primary wrist arthrodesis results are slightly more favorable than those for salvage of failed total wrist arthroplasty [12].
- There is an approximate 10% risk of secondary wrist arthrodesis in patients with persistent or progressive ulnar wrist pain following partial wrist denervation [13].
- Total wrist arthrodesis combined with proximal row carpectomy (PRC) provides reliable and reproducible benefits [15].
- Proximal row carpectomy provides good pain relief with preservation of wrist motion [17].
- Awareness of complications associated with wrist arthrodesis is essential for appropriately counseling patients on different options and expectations [18].
- Total wrist arthrodesis using a Wrist Fusion Rod is expected to provide long-lasting pain relief and stability in cases of severe wrist deterioration and ulnar carpal shift [23].
- Both proximal row carpectomy and four-corner fusion provide improvements in pain and subjective outcome measures for patients with symptomatic SLAC or SNAC wrists [29].
- Wrist arthrodesis using the AO Titanium Wrist Fusion Plate is an excellent option for treating various painful disorders of the wrist [34].
- Arthrodesis of the rheumatoid wrist was successful in all but two patients, resulting in increased strength and function [36].
Investigations
- Good and excellent clinical results following radiolunate fusion do not depend on the fixation device [3].
- Despite loss of wrist motion, most patients report satisfactory functional outcomes and are able to accomplish most daily activities with adaptation and compensation [11].
- Proximal row carpectomy using decellularized dermal allograft expands indications to include select patients with degeneration of the capitate head [16].
- Awareness of complications associated with wrist arthrodesis is essential for appropriate patient counseling on different arthrodesis options and expectations [18].
- Proximal row carpectomy (PRC) provides satisfactory postoperative wrist range of motion and grip strength with few complications, especially when there is no capitolunate arthrosis [24].
- Partial denervation of the wrist is feasible and efficacious as an alternative to arthrodesis [25].
- 26-33% of scaphoid fractures judged nondisplaced on radiograph were found to be displaced on CT scan [48].
- Resection followed by wrist arthrodesis and structural iliac bone graft achieved satisfactory oncologic and functional results, although one-third of patients experienced complications at a minimum of 10 years of follow-up [49].
- Radiological adaptation in the radiocapitate joint occurs after proximal row carpectomy (PRC) [51].
- Scaphoidectomy and midcarpal fusion is a useful salvage procedure in a variety of degenerative conditions [52].
Treatment
- Total wrist arthroplasty (TWA) and partial wrist arthroplasty have a noteworthy potential for complications requiring additional surgery [6].
- Total wrist arthrodesis provides reliable pain relief, good functional outcomes, and high patient satisfaction, particularly for end-stage arthritis and as a salvage technique [7].
- There is a low rate of conversion to total wrist arthrodesis following scaphoid excision and four-corner arthrodesis [9].
- Total wrist arthrodesis combined with PRC provides reliable and reproducible benefits [15].
- Patients undergoing proximal row carpectomy experience good pain relief with preservation of wrist motion [17].
- Total wrist arthroplasty and total wrist arthrodesis are both extremely cost-effective procedures [22].
- For stage II SLAC wrist with a preserved capitolunate joint, proximal row carpectomy is preferred because it is technically less demanding and yields durable results [32].
- Radioscapholunate arthrodesis with compression screws and local autograft is an effective method for appropriately selected patients with a preserved midcarpal joint, achieving a 100% union rate at mean follow-up of 12 months with no complications [33].
- Arthroplasty should be used as an alternative to arthrodesis for posttraumatic wrist arthritis given proper patient selection and indications [42].
- Limited data suggest that partial denervation procedures can provide short-term pain relief without altering proprioception, but future studies are needed to assess the duration of relief and possible acceleration of underlying pathology [46].
- Patients undergoing wrist arthrodesis with bone autograft and Hoffmann external fixation regained full finger movements and forearm rotation, though complete pain relief was rare and they had significant limitations in activities of daily living [47].
Complications
- There remains a noteworthy potential for complications requiring additional surgery following total wrist arthroplasty and partial wrist arthroplasty [6].
- Awareness of complications associated with wrist arthrodesis is essential for appropriately counseling patients on different arthrodesis options and informing them on what to expect from the procedure [18].
- Cautious patient selection and consideration of potential complications are crucial for good outcomes in wrist arthrodesis and soft tissue rebalancing for the spastic hand [55].
- Some intercarpal arthrodeses yield good, predictable outcomes, while others are infrequently used due to unpredictable results and high complication rates [61].
- Hardware complications were common in wrist arthrodesis for cerebral palsy, leading to a routine recommendation for hardware removal [60].
- The complication rate for the modified Clayton-Mannerfelt arthrodesis of the wrist in rheumatoid arthritis was low, and hardware did not have to be removed in most cases [53].
- Infection following wrist arthroplasty and arthrodesis is relatively uncommon in a nationally representative Medicare database cohort [58].
- There is an approximate 10% risk of secondary wrist arthrodesis in patients with inflammatory arthritis and persistent or progressive ulnar wrist pain following partial wrist denervation [13].
Recovery
- Proximal row carpectomy (PRC) and four-corner arthrodesis (FCA) demonstrated similarly low rates of conversion to total wrist arthrodesis [10].
- Despite the loss of wrist motion, most patients report satisfactory functional outcomes and are able to accomplish most daily activities of living with some adaptation and compensation [11].
- Results between primary wrist arthrodesis and salvage of failed total wrist arthroplasty were slightly in favour of patients with primary wrist arthrodesis [12].
- Patients undergoing proximal row carpectomy experienced good pain relief with preservation of wrist motion [17].
- While functional improvement was observed for wrist arthroplasty patients, robust long-term follow-up data on wrist arthroplasty are not yet available [20].
- Four-corner arthrodesis with a dorsal locking plate significantly reduced pain and significantly improved wrist function compared with preoperative status at a mean follow-up of 6 years [50].
- Four-corner bone wrist arthrodesis by dorsal rectangular plating achieves acceptable preservation of range of motion, good pain relief, an excellent consolidation rate, and minimal complications [54].
- Four-corner arthrodesis employing the native scaphoid as the principal donor graft demonstrates favourable functional outcomes for functionally demanding patients with Stage II or III collapse deformity [56].
Key Evidence
- [L4] Total wrist fusion should only be used in exceptional circumstances. [1] (10.1097/01.sap.0000194245.94684.54)
- [L4] Total wrist fusion should only be used for exceptional circumstances. [2] (10.1054/jhsb.2000.0434)
- [L4] Good and excellent clinical results in the majority of the patients following radiolunate fusion do not depend on the fixation device. [3] (10.1177/1753193409342054)
- [L4] RSL fusion is a palliative procedure that preserves some of the wrist's mobility but has a significant nonunion rate. [4] (10.1016/j.otsr.2017.07.012)
- [L4] They advocate nonspanning arthrodesis as an alternative method for total wrist fusion with a high union rate and minimal risk of complications at the carpometacarpal joint. [5] (10.1055/s-0037-1606257)
- [L4] Although TWA and partial wrist arthroplasty are attractive treatment options for the painful arthritic wrist, there remains a noteworthy potential for complications requiring additional surgery. [6] (10.1016/j.jhsa.2015.10.021)
- [L4] Total wrist arthrodesis provides reliable pain relief and good functional outcomes with high patient satisfaction, particularly for end-stage arthritis and as a salvage technique. [7] (10.5435/jaaos-d-15-00424)
- [L3] Additional studies are required to confirm these findings and investigate who may benefit from partial wrist denervation. [8] (10.1177/17531934261425490)
- [L4] There is a low rate of conversion to total wrist arthrodesis. [9] (10.1016/j.jhsa.2010.01.025)
- [L3] PRC and FCA demonstrated similarly low rates of conversion to total wrist arthrodesis. [10] (10.2106/jbjs.19.00965)
- [L5] Despite the loss of wrist motion, most patients report satisfactory functional outcomes, confirming that they are able to accomplish most daily activities of living with some adaptation and compensation. [11] (10.1016/j.hcl.2005.08.004)
- [L3] The results between the two groups were slightly in favour of patients with a primary wrist arthrodesis. [12] (10.1177/17531934211057389)
- [L4] Our findings suggest an approximate 10% risk of secondary wrist arthrodesis in patients with persistent or progressive ulnar wrist pain. [13] (10.1007/s10067-019-04645-8)
- [L5] Complications and reoperations occur frequently, most often due to incomplete bone fusion or hardware-related problems, and it remains unknown which implant type is best or if the carpometacarpal joint should be included. [14] (10.1177/17531934241295343)
- [Paper] Total wrist arthrodesis combined with PRC provides reliable and reproducible benefits. [15] (10.1016/j.otsr.2015.09.032)
- [L4] This technique adds another surgical option for the treatment of wrist arthritis and expands the indications for PRC to include select patients with degeneration of the capitate head. [16] (10.1016/j.jhsa.2018.01.012)
- [L3] Patients experienced good pain relief with preservation of wrist motion. [17] (10.1177/1753193415597096)
- [L4] Awareness of complications associated with wrist arthrodesis and how best to avoid them is essential for the treating physician to appropriately counsel patients on different arthrodesis options and to inform them on what to expect from the procedure. [18] (10.1016/j.hcl.2009.11.003)
- [L1] The newer fourth-generation wrist implants appear to be performing better than earlier designs. [19] (10.1055/s-0038-1646956)
- [L2] While functional improvement was observed for arthroplasty patients, robust long-term follow-up data on wrist arthroplasty are not yet available. [20] (10.1177/1753193420953683)
- [L3] Proximal row carpectomy is a motion-preserving salvage procedure with a low rate of conversion to wrist arthrodesis. [21] (10.1016/j.jhsa.2021.09.031)
- [L2] Total wrist arthroplasty and total wrist arthrodesis are both extremely cost-effective procedures. [22] (10.1016/j.jhsa.2009.12.013)
- [L4] Total wrist arthrodesis with Wrist Fusion Rod is expected to provide long-lasting pain relief and stability with severe wrist deterioration and ulnar carpal shift. [23] (10.1016/j.jhsg.2026.101024)
- [L5] PRC provides satisfactory postoperative wrist range of motion and grip strength with few complications, especially when there is no capitolunate arthrosis. [24] (10.1016/j.hcl.2012.08.022)
- [L4] The authors report preliminary clinical experience in 24 patients to demonstrate the feasibility and efficacy of this technique as an alternative to arthrodesis. [25] (10.1097/00130911-199803000-00004)
- [L3] Radialization/lateralization of the translocated ulna achieved from the alignment with the second metacarpal decreases the reduction in the wrist circumference and therefore reduces wrist narrowing. [27] (10.1097/corr.0000000000001604)
- [L4] While there are some significant differences in range of motion and grip strength, these differences are unlikely to be clinically relevant. [28] (10.1016/j.jhsa.2021.06.002)
- [L4] Both procedures provide improvements in pain and subjective outcome measures for patients with symptomatic and appropriately staged SLAC or SNAC wrists. [29] (10.1177/1753193408100954)
- [L4] PRC individuals demonstrated improved performance and greater wrist motion compared to MA during hammering. [30] (10.1016/j.jht.2011.07.007)
- [L4] The PRC provided improved flexion-extension with a circumduction curve concentric with the nonsurgical wrist. [31] (10.1016/j.jhsa.2014.09.005)
- [L4] For stage II SLAC wrist with a preserved capitolunate joint, proximal row carpectomy is preferred because it is technically less demanding and yields durable results. [32] (10.5435/00124635-200307000-00007)
- [L4] This technique is an effective method to perform radioscapholunate arthrodesis in appropriately selected patients with a preserved midcarpal joint, achieving a 100% union rate at mean follow-up of 12 months with no complications. [33] (10.1016/j.jhsa.2013.01.026)
- [L4] Wrist arthrodesis with the AO/ASIF Titanium wrist fusion plate is an excellent option for treatment of various painful disorders of the wrist. [34] (10.1054/jhsb.2001.0600)
- [L3] Most tasks were performed significantly quicker by the patients after proximal row carpectomy. [35] (10.1177/1753193416638812)
- [L4] The technique addresses critical stabilizers to prevent carpal instability and collapse. [37] (10.1016/j.jhsa.2024.10.019)
- [L3] Although wrist motion following 4CF correlates positively with preoperative motion, most patients do not differ significantly in postoperative motion. [38] (10.1016/j.jhsa.2022.06.011)
- [L4] Wrist arthrodesis is a well-established procedure that predictably relieves pain and provides a stable wrist for power grip. [39] (10.5435/00124635-200101000-00006)
- [L4] Proximal row carpectomy has improved motion and fewer complications. [40] (10.1016/j.jhsa.2017.03.015)
- [L3] Arthrodesis of the reconstructed radiocarpal joint provided better grip strength and functional outcomes than arthroplasty. [41] (10.1177/1753193418809785)
- [L3] Arthroplasty should be used as an alternative to arthrodesis in the treatment of posttraumatic wrist arthritis, given the proper patient selection and indications. [42] (10.1016/j.jhsa.2013.02.013)
- [L4] The choice of procedure depends on the pattern of wrist destruction and stability, with radiolunate arthrodesis being effective for unstable wrists with preserved midcarpal joint space. [43] (10.1016/j.hcl.2005.08.005)
- [L4] The results were comparable to or better than previously published techniques in terms of fusion rates, alleviation of pain, grip strength, range of motion, Mayo wrist score, and Disabilities of the Arm, Shoulder, and Hand questionnaire score. [44] (10.1016/j.jhsa.2011.12.022)
- [L4] The study demonstrates that limited wrist arthrodesis techniques are reliable and effective for a wide range of wrist disorders, with low complication rates and high patient satisfaction. [45] (10.1054/jhsb.1999.0066)
- [L4] Limited data suggest that partial denervation procedures can provide short-term pain relief without altering proprioception, but future studies are needed to assess the duration of relief and possible acceleration of underlying pathology. [46] (10.1016/j.jhsa.2017.12.012)
- [L4] All patients regained full finger movements and rotation of the forearm, though complete pain relief was rare and patients had significant limitations in activities of daily living. [47] (10.1177/1753193411416565)
- [L3] 26-33% of scaphoid fractures were judged nondisplaced on radiograph, but displaced on CT scan. [48] (10.1016/j.jhsa.2015.06.021)
- [L2] Resection followed by wrist arthrodesis and structural iliac bone graft achieved satisfactory oncologic and functional results, albeit with one-third of all patients experiencing some complications at a minimum of 10 years of follow-up. [49] (10.1097/corr.0000000000003738)
- [L4] At a mean follow-up of 6 years, pain was significantly reduced and wrist function was significantly improved compared with preoperative status. [50] (10.1177/1753193420930587)
- [Paper] Radiological adaptation in the radiocapitate joint after PRC was found in this study. [51] (10.1016/j.otsr.2020.03.038)
- [L4] Scaphoidectomy and midcarpal fusion is a useful salvage procedure in a variety of degenerative conditions. [52] (10.1177/1753193410395357)
- [L4] The complication rate was low, and the hardware did not have to be removed in most cases. [53] (10.1016/j.jhsa.2013.02.029)
- [L4] Four-corner bone wrist arthrodesis by dorsal rectangular plating achieves an acceptable preservation of range of motion with good pain relief, an excellent consolidation rate and minimal complications. [54] (10.1177/1753193409105684)
- [L4] Cautious patient selection and consideration of potential complications are crucial for good outcomes. [55] (10.1177/17531934231205548)
- [L4] For functionally demanding patients with Stage II or III collapse deformity, this method demonstrates favourable functional outcomes. [56] (10.1177/1753193416676663)
- [L3] Infection following wrist arthroplasty and arthrodesis is relatively uncommon in a nationally representative Medicare database cohort. [58] (10.1177/1558944719890036)
- [L4] Hardware complications were common, and consequently, the authors now routinely recommend hardware removal. [60] (10.1016/j.jhsa.2009.03.006)
- [L5] While some procedures yield good, predictable outcomes, others are infrequently used due to unpredictable results and high complication rates. [61] (10.1016/j.jhsa.2013.09.014)
References
[1] Long-Term Results of Midcarpal Arthrodesis in the Treatment of Scaphoid Nonunion Advanced Collapse (SNAC-Wrist) and Scapholunate Advanced Collapse (SLAC-Wrist). Annals of Plastic Surgery. 2006. DOI: 10.1097/01.sap.0000194245.94684.54
[2] Midcarpal Arthrodesis with Complete Scaphoid Excision and Interposition Bone Graft in the Treatment of Advanced Carpal Collapse (SNAC/SLAC Wrist): Operative Technique and Outcome Assessment. Journal of Hand Surgery. 2000. DOI: 10.1054/jhsb.2000.0434
[3] Radiolunate fusion in the rheumatoid wrist with Shapiro staples: clinical and radiological results of 22 cases. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193409342054
[4] Clinical and radiological outcomes following radioscapholunate fusion. Orthopaedics & Traumatology: Surgery & Research. 2017. DOI: 10.1016/j.otsr.2017.07.012
[5] Nonspanning Total Wrist Arthrodesis with a Low-Profile Locking Plate. Journal of Wrist Surgery. 2017. DOI: 10.1055/s-0037-1606257
[6] Complications Following Partial and Total Wrist Arthroplasty: A Single-Center Retrospective Review. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2015.10.021
[7] Total Wrist Arthrodesis: Indications and Clinical Outcomes. Journal of the American Academy of Orthopaedic Surgeons. 2017. DOI: 10.5435/jaaos-d-15-00424
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