title: Factors predictive of patient outcome following total wrist arthrodesis.
abstract: OBJECTIVE
  Total wrist arthrodesis (TWA) produces a spectrum of outcomes. We investigated this by reviewing 77 consecutive TWA performed for inflammatory and post-traumatic arthropathies, wrist instability and as a salvage procedure.
  
  
  METHODS
  All operations were performed by a single surgeon using a specifically designed pre-contoured dorsally applied non-locking wrist arthrodesis plate at a single centre.
  
  
  RESULTS
  Median post-operative Buck-Gramcko Lohman (BGL), Disabilities of the Arm, Shoulder and Hand and Patient Rated Wrist Evaluation scores at six years (interquartile range (IQR) 3 to 11) were 9 (IQR = 6 to 10), 19 (IQR = 7 to 45) and 13 (IQR = 1 to 31) respectively. Polyarticular inflammatory arthritis and female gender were associated with poorer patient-reported outcomes, although the effect of gender was partly explained by higher rates of inflammatory disease among women. Return to work was negatively influenced by workers' compensation and non-inflammatory wrist pathology. There was no difference in complication rates for inflammatory and non-inflammatory indications.
  
  
  CONCLUSIONS
  Polyarticular inflammatory arthritis is a risk factor for adverse patient-reported outcomes in TWA. Furthermore, when compared with patients without inflammatory arthritis, dorsally applied pre-contoured plates can be used for wrist arthrodesis in patients with inflammatory arthritis without an increased risk of complications. Cite this article: Bone Joint J 2016;98-B:647-53.
authors.affiliation: The Canberra Hospital , Building 6 Level 1, PO Box Woden ACT 2606, Australia and Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra ACT, 0200, Australia.
authors.forename: D H
authors.initials: DH
authors.lastname: Owen
authors.affiliation: McFarlane Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia.
authors.forename: P A
authors.initials: PA
authors.lastname: Agius
authors.affiliation: Sydney Spine Doctor, Post Office Box 8139 Westpoint Blacktown, New South Wales 2148, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Nair
authors.affiliation: The Canberra Hospital, Building 6 Level 1, PO Box Woden ACT 2606, Australia.
authors.forename: D M
authors.initials: DM
authors.lastname: Perriman
authors.affiliation: The Canberra Hospital, Building 6 Level 1, PO Box Woden ACT 2606, Australia and Professor, Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra ACT, 0200, Australia.
authors.forename: P N
authors.initials: PN
authors.lastname: Smith
authors.affiliation: The Canberra Hospital, Building 6 Level 1, PO Box Woden ACT 2606, Australia and Professor, Australian National University Medical School, Level 2 Peter Baume Building 42, Linneaus Way, Canberra ACT, 0200, Australia.
authors.forename: C J
authors.initials: CJ
authors.lastname: Roberts
mesh_terms: D000368:Aged; D001168:Arthritis / Q000601:surgery; D001174:Arthrodesis; D001860:Bone Plates; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D062707:Return to Work / Q000706:statistics & numerical data; D012737:Sex Factors; D013585:Synovitis / Q000601:surgery; D014942:Workers' Compensation / Q000706:statistics & numerical data; D014955:Wrist Joint / Q000601:surgery*
keywords: Arthritis; Arthrodesis; DASH; Fusion; PRWE; Patient reported outcomes; Workers compensation; Wrist