AO-wrist arthrodesis: with and without arthrodesis of the third carpometacarpal joint.
The incorporation of the third carpometacarpal joint (CMCJ-3) during wrist arthrodesis is controversial. This retrospective study of 146 consecutive wrist arthrodeses with AO plate fixation specifically addresses this question. In 79 wrist arthrodeses the CMCJ-3 was also arthrodesed, and in 67 the CMCJ-3 was simply bridged. Problems relating specifically to the CMCJ-3 could not be analyzed clearly with the plate in situ. Therefore after plate removal only 81 wrists were evaluated with respect to the CMCJ-3. Of 47 wrists that had CMCJ-3 arthrodesis and plate removal, 20 developed a nonunion. Eleven of these were painful and further surgical treatment was required. In contrast, of 34 wrists with the CMCJ-3 bridged all but one remained free of symptoms after the plate had been removed. We conclude that the CMCJ-3 must not be included in the arthrodesis when performing an AO-wrist arthrodesis.
Nagy
Ladislav
L
Hand Surgery Division, University of Bern/Inselspital, Bern, Switzerland.
Büchler
Ueli
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000009:adverse effects* / Q000379:methods*; D001860:Bone Plates; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D008297:Male; D008662:Metacarpophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012086:Reoperation; D012189:Retrospective Studies; D014025:Titanium; D016896:Treatment Outcome; D014955:Wrist Joint / Q000601:surgery*
D014025:Titanium