title: WRIST ARTHRODESIS WITH MINIMAL FIXATION PRESERVING THE CARPOMETACARPAL JOINTS.
abstract: OBJECTIVE
  Wrist arthrodesis is a surgical procedure that should always be considered in cases of pathological conditions in which anatomical and functional structures are altered. In general, the results are very satisfactory, particularly for pain relief, and in the majority of cases, there is considerable functional improvement. Various techniques have been described, with different methods of internal fixation, most of which include the carpometacarpal joints in the fusion. The objective of this study was to evaluate the results from wrist arthrodesis using a technique that is simpler, more biological, less expensive, and does not involve the carpometacarpal joints.
  
  
  METHODS
  Fifteen patients with wrist arthrodesis were evaluated (six with sequelae from trauma, four with rheumatoid arthritis, three with Kienbock grade IV, one with Preiser and one with panarthrosis). The technique consisted of using an iliac bone plate and internal fixation with Kirschner wires, avoiding the carpometacarpal joints.
  
  
  RESULTS
  The evaluation was based on consolidation time (93% in seven weeks); movements of the fingers and pronosupination; pinch and grasp strength; functional evaluation through the DASH, pain and patient satisfaction questionnaires. In general, the results were similar to those of other, more aggressive techniques, and the non-inclusion of the carpometacarpal joints did not affect the final result.
  
  
  CONCLUSIONS
  Wrist arthrodesis with fixation using Kirschner wires and an iliac bone plate, preserving the carpometacarpal joints, gives good or excellent results that are not inferior to those of other techniques that have been described. However, it presents major advantages over other methods: it is less aggressive and cheaper, and does not have the inconvenience and complications associated with the use of plates and screws.
authors.affiliation: Full Professor of Orthopedics and Traumatology. Head of the Hand Surgery Service at the Orthopedics Hospital of Belo Horizonte.
authors.forename: Arlindo Gomes
authors.initials: AG
authors.lastname: Pardini
authors.affiliation: Former Resident in the Hand Surgery Service at the Orthopedics Hospital of Belo Horizonte.
authors.forename: Rodolfo Fonseca
authors.initials: RF
authors.lastname: Pádua Gonçalves
authors.affiliation: Hand Surgeon at the Orthopedics Hospital of Belo Horizonte.
authors.forename: Afrânio Donato
authors.initials: AD
authors.lastname: Freitas
authors.affiliation: Hand Surgeon at the Orthopedics Hospital of Belo Horizonte.
authors.forename: Antonio Barbosa
authors.initials: AB
authors.lastname: Chaves
keywords: Arthrodesis; Bone graft; Carpometacarpal joint; Internal fixators; Wrist