Radiolunate fusion in the rheumatoid wrist via three point fixation with a mini-titanium-T-plate and oblique screw

Abstract

Traditional surgical techniques for radiolunate arthrodesis typically result in an unsatisfactory primary stability. Thus cast immobilisation is implemented until bone healing is complete. Nonunion and implant dislocation are frequent complications. Eighteen patients (20 wrists) with rheumatoid disease who had undergone a radiolunate arthrodesis procedure using a mini-titanium-T-plate with an oblique screw were examined. The high primary stability of this fusion depends on three point fixation. Complete bone healing was achieved in all wrists. Dislocation of a screw occurred in one wrist which subsequently healed in mild dislocation. Grip strength improved in 12 hands with pain relief in 19 wrists. 18 patients rated the result of the operation as "very good" or "good" and would agree to have the operation again. The mini-titanium-T-plate with oblique screw achieves high primary stability via three point fixation of the lunate at the radius. Thus, postoperative immobilisation in a cast is unnecessary. The procedure is well tolerated by patients with a high satisfaction rating.