J Wrist Surg 2013; 02(04): 324-329
DOI: 10.1055/s-0033-1357759
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Can Total Wrist Arthroplasty Be an Option in the Treatment of the Severely Destroyed Posttraumatic Wrist?

Michel E. H. Boeckstyns
1   Section of Hand Surgery, Gentofte Hospital/University of Copenhagen, Denmark
,
Guillaume Herzberg
2   Wrist Surgery Unit, Department of Orthopaedics, Claude Bernard Lyon University, Herriot Hospital, Lyon, France
,
Allan Ibsen Sørensen
3   Section of Hand Surgery, Sahlgrenska Hospital, Gothenburg, Sweden
4   Section of Hand Surgery, Rigshospitalet, Copenhagen, Denmark
,
Peter Axelsson
5   Section of Hand Surgery, Sahlgrenska Hospital, Gothenburg, Sweden
,
Karsten Krøner
6   Section of Hand Surgery, Aarhus University Hospital, Aarhus, Denmark
,
Philippe A. Liverneaux
7   Hand Surgery Unit, Orthopaedic Department, Strasbourg University, Strasbourg, France
,
Laurent Obert
8   Hand Surgery Unit, Orthopaedic Department, Besançon University, Besançon, France
,
Søren Merser
9   Technical University of Denmark, Lyngby, Denmark
› Author Affiliations
Further Information

Publication History

Publication Date:
08 November 2013 (online)

Abstract

Background Severely destroyed posttraumatic wrists are usually treated by partial or total wrist fusion or proximal row carpectomy. The indications for and longevity of total wrist arthroplasty (TWA) are still unclear.

Case Description The aim of this study was to analyze a series in which one last-generation total wrist arthroplasty was used as a salvage procedure for wrists with severe arthritis due to traumatic causes. The data were prospectively recorded in a web-based registry. Seven centers participated. Thirty-five cases had a minimum follow-up time of 2 years. Average follow-up was 39 (24–96) months. Pain had improved significantly at follow-up, mobility remained unchanged. The total revision rate was 3.7%, and the implant survival was 92% at 4–8 years.

Literature Review Very few studies have described specific results after TWA in posttraumatic cases and almost none using classical “third-generation” implants. The number of cases and the follow-up in the published series are small.

Clinical Relevance Although painful posttraumatic wrists with severe joint destruction can be salvaged by partial or total fusion, we found that, evaluated at short- to midterm, total wrist arthroplasty can be an alternative procedure and gives results that are comparable to those obtained in rheumatoid cases.

Level IV Case series

 
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