Can total wrist arthroplasty be an option in the treatment of the severely destroyed posttraumatic wrist?
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.
Section of Hand Surgery, Gentofte Hospital/University of Copenhagen, Denmark.
Michel E H
ME
Boeckstyns
Wrist Surgery Unit, Department of Orthopaedics, Claude Bernard Lyon University, Herriot Hospital, Lyon, France.
Guillaume
G
Herzberg
Section of Hand Surgery, Sahlgrenska Hospital, Gothenburg, Sweden ; Section of Hand Surgery, Rigshospitalet, Copenhagen, Denmark.
Allan Ibsen
AI
Sørensen
Section of Hand Surgery, Sahlgrenska Hospital, Gothenburg, Sweden.
Peter
P
Axelsson
Section of Hand Surgery, Aarhus University Hospital, Aarhus, Denmark.
Karsten
K
Krøner
Hand Surgery Unit, Orthopaedic Department, Strasbourg University, Strasbourg, France.
Philippe A
PA
Liverneaux
Hand Surgery Unit, Orthopaedic Department, Besançon University, Besançon, France.
Laurent
L
Obert
Technical University of Denmark, Lyngby, Denmark.
Søren
S
Merser
posttraumatic; prospective; total wrist arthroplasty; wrist arthritis; wrist arthrosis