title: Wrist arthrodesis for failed wrist implant arthroplasty.
abstract: Thirteen wrist arthrodeses were performed for failed wrist implant arthroplasties between 1984 and 1992. Twelve patients were available for review, with an average follow-up period of 28 months. The original arthroplasties consisted of 8 silicone implants and 4 metal-plastic total wrist implants. The surgical method involved a tricortical iliac bone graft and an intramedullary Steinmann pin. There were 7 excellent results, 4 good results, and 1 poor result. All but 1 patient had markedly improved function with no or mild pain. Seven patients had solid fusions and 5 patients had pseudarthroses. Four pseudarthroses occurred at the graft-metacarpal junction and 1 occurred at the graft-radius junction. Each patient with a solid fusion had an excellent result. All graft-metacarpal pseudarthroses were painless and did not limit the patients' activities. There were 17 complications in 9 patients. Wrist arthrodesis can be a successful salvage procedure for failed wrist implant arthroplasty in patients with rheumatoid arthritis. However, the complication rate can be high. Owing to the high incidence of distal graft-metacarpal pseudarthrosis, we recommend using more rigid fixation techniques in patients with failed wrist arthroplasties.
authors.affiliation: Tucson Orthopaedic Institute, AZ, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Beer
authors.forename: R H
authors.initials: RH
authors.lastname: Turner
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000601:surgery; D001174:Arthrodesis / Q000009:adverse effects; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008875:Middle Aged; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012086:Reoperation; D014955:Wrist Joint / Q000601:surgery*