HS13P TOTAL WRIST ARTHROPLASTY‐A REVIEW OF PATIENTS WITH DYSFUNCTIONAL WRISTS

Abstract

Background: The wrist is essential for augmentation of fine motor control of the hand and fingers. The normal wrist motion involves a complex interaction of articulations from the radius, ulna and carpal bones. Hence, when a disease process disrupts any one of these elements, a painful, deformed and dysfunctional wrist arises. Total wrist arthroplasty is considered an alternative surgical option to wrist fusion for the management of advanced wrist arthritic diseases. Though less commonly performed in comparison to lower‐limb arthroplasty, wrist arthroplasty has its role as a salvage procedure to alleviate pain and preserve function in the wrists.Method: Four patients were collected from the Centre of Hand Surgery, Sydney. Medical records of these patients were reviewed. The patient's pre‐and post‐operative functional status via clinical and radiographic assessments were closely followed over an average period of five years to ensure the continuity of progress. A table was formulated to provide an objective survey of both quantitative and qualitative improvement of a patient's wrist function.Result: The four patients received different types of prostheses. This is an indication of a lack of universal acceptance of wrist anatomy and biomechanics. Regardless, all patients in this study had improved functional outcomes. Pain‐relief was the most successful aspect of wrist arthroplasty during post‐operative follow‐ups. The successful outcome of these patients has proven that total wrist arthroplasty can provide pain relief and an improvement in hand function through appropriate patient selections, careful peri‐operative planning, sound operative technique and well‐designed post‐operative hand therapy.