Wrist arthrodesis after failed wrist implant arthroplasty

Abstract

Wrist arthroplasty has not achieved large success to date, and there are patients with failures in their procedures who will need arthrodesis. We review our experience in revising a wrist implant arthroplasty to an arthrodesis with a block graft of fresh-frozen allograft femoral head or iliac crest bone graft. Fixation was achieved with an intramedullary Steinmann pin. Ten patients with 12 failed wrist implants required wrist arthrodesis; 7 had wrist arthrodesis with a bulk allograft femoral head, 4 with an iliac crest bone autograft, and 1 without a bone graft. After an average follow-up period of 5 years, all patients were pain free and fusion had been achieved. Complications included 1 patient with acute carpal tunnel syndrome, 2 patients with nonunions requiring secondary bone grafting procedures, and 2 patients requiring revisions of their intramedullar pins. In both nonunions, iliac crest bone graft was used for the initial arthrodesis. All the patients were satisfied. Arthrodesis after failed wrist implant arthroplasty is a satisfactory procedure, and a fresh-frozen allograft can be used effectively in wrist fusion.