Four Corner Intercarpal Arthrodesis

2009 ◽  
Author(s):  
Gregory Rafijah
Keyword(s):  
Ligament Injury ◽  
Bony Union ◽  
Proximal Row Carpectomy ◽  
Non Union ◽  
Scapholunate Ligament Injury ◽  
Post Traumatic ◽  
Wrist Fusion ◽  
Traumatic Arthritis ◽  
Intercarpal Arthrodesis

Intercarpal arthrodesis is a common motion sparring procedure for post-traumatic arthritis of the wrist. Untreated scaphoid non-union or scapholunate ligament injury often leads to progressive arthritis of the wrist that can be salvaged by proximal row carpectomy (PRC), limited intercarpal arthrodesis or total wrist fusion. Most surgeons elect to perform a motion sparring procedure in lieu of total wrist fusion. PRC is favored by many because of the ease of surgery and no need to obtain bony union. However, several reports are pessimistic about the out comes of the PRC operation in the long term. Most agree that the four corner arthrodesis with scaphoid excision is the optimal reconstruction to maintain wrist motion and strength and provide long-term durability.

Long-Term Results of Radioscapholunate Fusion Following Fractures of the Distal Radius

1997 ◽  
Vol 22 (6) ◽  
pp. 705-710 ◽  
Author(s):  
L. NAGY ◽  
U. BÜCHLER
Keyword(s):  
Long Term Results ◽  
Short Term ◽  
Non Union ◽  
Partial Fusion ◽  
Traumatic Lesions ◽  
Residual Motion ◽  
Radioscapholunate Fusion ◽  
Wrist Fusion

Fifteen patients with radioscapholunate (RSL) fusion for traumatic lesions of the radiocarpal junction, whose short-term results have been previously reported, were reassessed after an average follow-up time of 8 years. Five patients had undergone wrist fusion because of non-union or early progressive arthritis. Of the ten wrists with retained mobility, eight continued to function satisfactorily. Two wrists were painful for reasons other than secondary midcarpal arthritis. Patient satisfaction was comparable in both groups with the wrist score better for wrists with residual motion. The survival of RSL partial wrist fusion corresponded inversely with the number of preceding operations and the range of motion before partial fusion. Secondary midcarpal arthritis, if present, arose early and was well tolerated. Failures were strongly linked to technical mistakes and complications.

scholarly journals A prospective study on outcome of function after proximal row carpectomy

2019 ◽  
Vol 6 (1) ◽  
pp. 44
Author(s):  
Chaitanya Gadi ◽  
S. M. Venugopal ◽  
Bhaskaranand Kumar ◽  
Karthik Gudaru
Keyword(s):  
Prospective Study ◽  
Grip Strength ◽  
Neuromuscular Disorders ◽  
Wrist Flexion ◽  
Proximal Row Carpectomy ◽  
Significant Difference ◽  
Post Traumatic ◽  
A Prospective Study ◽  
Traumatic Arthritis

<p class="abstract"><strong>Background:</strong> Proximal row carpectomy (PRC) is a procedure with varied indications. The purpose of this study was to evaluate functional outcomes with PRC in wrist flexion deformities, neuromuscular disorders and also post-traumatic wrist arthritis.</p><p class="abstract"><strong>Methods:</strong> A prospective study was performed on all patients who underwent PRC between April 2015 and December 2017, in BIRRD (T) hospital, Tirupati, Andhra Pradesh with a minimum follow up of 6 months. Outcome was assessed in terms of range of motion (ROM), grip strength, quick disabilities of the arm, shoulder, and hand (QDASH) score and pain score. Data was analyzed using the Student t-test.<strong></strong></p><p class="abstract"><strong>Results:</strong> Thirty-two patients underwent PRC of which 12 are neuromuscular disorders, 10 are wrist flexion deformities, 10 are post-traumatic wrist arthritis. On the final follow-up, significant improvement in ROM was observed in wrist flexion deformities and neuromuscular disorders, whereas grip strength and QDASH scores showed a significant difference in post-traumatic wrist arthritis. Pain was studied only in post-traumatic wrist arthritis, all were very much pleased with pain reduction.</p><p class="abstract"><strong>Conclusions:</strong> PRC is fairly a reliable procedure for all the indications in our study. We consider that PRC is a promising procedure in correcting wrist flexion deformities. Though there has been significant improvement in all the parameters for all the cases, we consider this procedure is best suited for post-traumatic arthritis group.</p>

Long-Term Results Following Ankle Arthrodesis for Post-Traumatic Arthritis

2001 ◽  
Vol 83 (2) ◽  
pp. 219-228 ◽  
Author(s):  
Lisa M. Coester ◽  
Charles L. Saltzman ◽  
John Leupold ◽  
William Pontarelli
Keyword(s):  
Ankle Arthrodesis ◽  
Long Term Results ◽  
Post Traumatic ◽  
Traumatic Arthritis

Total Hip Arthroplasty in Young Patients with Post-Traumatic Arthritis of the Hip

2017 ◽  
Vol 27 (6) ◽  
pp. 546-550 ◽  
Author(s):  
Ishaan Swarup ◽  
Ryan Sutherland ◽  
Jayme C. Burket ◽  
Mark P. Figgie
Keyword(s):  
Patient Reported Outcomes ◽  
Young Patients ◽  
Implant Survival ◽  
Long Term Outcomes ◽  
Patient Reported ◽  
Revision Tha ◽  
Post Traumatic ◽  
Traumatic Arthritis

Background Post-traumatic arthritis of the hip is a degenerative condition that commonly affects young patients. In this study, we evaluate long-term implant survival and patient-reported outcomes after primary total hip arthroplasty (THA) in patients aged 35 or younger with post-traumatic arthritis of the hip. Methods We conducted a retrospective study with follow-up. A chart review was performed to identify young patients with post-traumatic arthritis of the hip treated with primary THA. Follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Implant survival was assessed using Kaplan-Meier survival analysis, and patient outcomes were determined using the hip disability and osteoarthritis outcome score (HOOS). Results We studied 42 patient s (44 THAs) with a mean time to follow-up of 14 years. The 10-year implant survival rate was 87% and 20-year implant survival rate was 41%. Implant survival did not differ based on patient age, gender, implant type, bearing surface, or use of cement for implant fixation (p>0.05). The mean HOOS scores at follow-up were 87 for pain, 85 for symptoms, 89 for ADLs, and 76 for sports. HOOS scores were significantly worse in patients that had undergone revision THA (p<0.05). Conclusions Young patients with post-traumatic arthritis of the hip have good long-term outcomes after THA. However, revision THA is predictive of worse long-term outcomes.

Anterior cruciate ligament injury: post-traumatic bone marrow oedema correlates with long-term prognosis

2015 ◽  
Vol 40 (1) ◽  
pp. 183-190 ◽  
Author(s):  
Giuseppe Filardo ◽  
Elizaveta Kon ◽  
Francesco Tentoni ◽  
Luca Andriolo ◽  
Alessandro Di Martino ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Bone Marrow Oedema ◽  
Ligament Injury ◽  
Post Traumatic ◽  
Anterior Cruciate ◽  
Long Term Prognosis

Wrist Arthrodesis with the AO Titanium Wrist Fusion Plate: A Consecutive Series of 42 Cases

2001 ◽  
Vol 26 (4) ◽  
pp. 355-359 ◽  
Author(s):  
S. HOUSHIAN ◽  
H. A. SCHRØDER
Keyword(s):  
Rheumatoid Arthritis ◽  
Consecutive Series ◽  
Functional Evaluation ◽  
Wrist Arthrodesis ◽  
Time Of Surgery ◽  
Post Traumatic ◽  
Wrist Fusion ◽  
Traumatic Arthritis ◽  
Volkmann's Contracture

In a 4 year period (1996–1999), 42 total wrist fusions in 25 men and 17 women were performed using the AO/ASIF Titanium wrist fusion plate. The median age of the patients at the time of surgery was 41 (range, 19–72) years. The indication for fusion was post-traumatic arthritis in 29 wrists, Kienböck’s disease in eight, rheumatoid arthritis in three, mono-arthritis in one and Volkmann’s contracture in one. All patients were reviewed at a median follow-up of 23 (range, 6–50) months. The Buck–Gramcko and Lohmann score for functional evaluation was excellent in 35, good in 5 and satisfactory in 2 patients. We conclude that wrist arthrodesis with the AO/ASIF Titanium wrist fusion plate is an excellent option for treatment of various painful disorders of the wrist.

scholarly journals Revision Arthrodesis of the Subtalar Joint

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0041
Author(s):  
Joseph Tracey ◽  
Cyrus Taghavi ◽  
Shuyuan Li ◽  
Mark Myerson
Keyword(s):  
Ankle Arthrodesis ◽  
High Rate ◽  
Bone Block ◽  
Rigid Fixation ◽  
Non Union ◽  
Subtalar Arthrodesis ◽  
Invaluable Tool ◽  
Post Traumatic ◽  
Adjusted Rate ◽  
Traumatic Arthritis

Category: Hindfoot Introduction/Purpose: Subtalar arthrodesis is an invaluable tool in managing arthritis, deformity, and muscular imbalance of the hindfoot. However, failed arthrodesis is complicated by bone necrosis, sclerosis with loss of bone, less than ideal biologic settings, and the literature reports a high rate of non-union. The aim of this study was to review all subtalar arthrodeses performed within a single institution, and specifically describe the management of non-union. Methods: 492 consecutive subtalar arthrodesis cases were retrospectively analyzed between October 2001 and July 2013. From the primary arthrodesis group 91 (18%) were treated for subtalar coalition (100% arthrodesis), and were excluded to better depict the arthrodesis rate; the remaining 401 patients were treated primarily for post-traumatic arthritis. Pertinent demographics, comorbidities, and clinical notes were all retrieved through the electronic medical record and radiographs were reviewed through a PACS system. Results: 49 patients with a mean age of 49 years (range 23 - 80) presented with subtalar non-union (overall rate 10%, adjusted rate 18%). 41 (84%) underwent revision at a mean of 16.2 months (range 2.8 - 57.1) from the index arthrodesis. The rate of revision arthrodesis was 78%, 21/30 (70%) in situ arthrodeses, 7/7 bone block arthrodesis (p=.028), and 4/4 triple arthrodesis (p=.028). Arthrodesis was present at a mean of 3.4 months (range 1.6 - 7.6). 4/9 (44%) of the recurrent nonunions elected to abstain from surgery. Of the 5 remaining patients, 2/5 had a successful third attempt at arthrodesis, 1/5 had an additional nonunion followed by a successful fourth attempt at arthrodesis, 1/5 had a successful tibiotalocalcaneal arthrodesis, and 1/5 required a below-knee amputation. Conclusion: Risk factors identified for non-union were post-traumatic arthritis, ipsilateral ankle arthrodesis, and individual patient factors (smoking, diabetes, and infection). Different methods of screw fixation were not found to be significantly different between the fused and nonunion groups. Despite directed management to obtain rigid fixation and adequate compression, the rates of subtalar arthrodesis from primary (82%), revision (78%) and secondary revision (60%) cases were very poor with the exception of the group which underwent a bone block arthrodesis (100%, p=.028).

Motec Wrist Arthroplasty: 4 Years of Promising Results

2018 ◽  
Vol 23 (03) ◽  
pp. 364-368 ◽  
Author(s):  
L. Giwa ◽  
A. Siddiqui ◽  
G. Packer
Keyword(s):  
Patient Demographics ◽  
Total Wrist Arthroplasty ◽  
Metal On Metal ◽  
Flexion Extension ◽  
Post Traumatic ◽  
Wrist Fusion ◽  
Wrist Function ◽  
Traumatic Arthritis ◽  
Wrist Arthroplasty

Background: The Motec cementless modular metal-on-metal ball-and-socket wrist arthroplasty is an implant with promising intermediate results. An alternative to primary wrist fusion, total wrist arthroplasty is an option for active patients, who wish to retain their wrist function. It is indicated in cases of degenerative osteoarthritis, post-traumatic arthritis and rheumatoid (inflammatory) arthritis. Methods: A prospective review of patient demographics, pre and post-operative Disabilities of the Arm Shoulder and Hand (DASH), MAYO scores, range of movements and grip strengths. All complications in follow up were recorded across the 4 year period. Results: 25 implants on 23 patients over 5.5 years, mean age 61; 8 females and 15 male. 10 patients with SLAC, 3 SNAC, 5 inflammatory and 7 patients with generalized osteoarthritis. The patients showed significant improvements of MAYO and DASH scores post-operatively, as well as the flexion/extension arc and grip strengths. There was just one case of implant loosening- the radial screw after a wound infection, which was revised with a longer screw. Two implants were converted to Motec fusion due to pain. One implant was dislocated and relocated. The remaining patients have had good wrist function. Only 6 patients were unable to return to work. Conclusions: Similar to published studies, this series shows the Motec implant to be a good motion preserving alternative to total wrist fusion.

A Long-Term Review of the Harrison-Nicolle Peg in Digital Arthrodesis

1991 ◽  
Vol 16 (3) ◽  
pp. 283-285 ◽  
Author(s):  
P. L. SANDERSON ◽  
M. A. MORRIS ◽  
N. R. M. FAHMY
Keyword(s):  
Clinical Outcome ◽  
Joint Disease ◽  
Bony Union ◽  
Inflammatory Joint Disease ◽  
Non Union

Fifty arthrodeses of the digital joints using the Harrison-Nicolle peg in 22 patients have been reviewed at a mean of 8.5 years after operation. 96% of these operations were judged to have been successful by our patients, most of whom were suffering from inflammatory joint disease. 66% went on to bony union, 30% to fibrous union and 4% to non-union. There was no difference in clinical outcome between the bony and fibrous union groups and only those with non-union were disappointed. All arthrodeses remained in the same angle of flexion as that in which they were originally fixed.

Seven-Year Outcome Following Colles’ Type Distal Radial Fracture. A Comparison of Two Treatment Methods

2003 ◽  
Vol 28 (5) ◽  
pp. 405-408 ◽  
Author(s):  
C. F. YOUNG ◽  
A. M. NANU ◽  
R. G. CHECKETTS
Keyword(s):  
External Fixation ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Range Of Movement ◽  
Post Traumatic ◽  
Function Range ◽  
High Level ◽  
Traumatic Arthritis ◽  
Plaster Immobilization

Eighty-five patients were reviewed 7 years after prospective randomization to bridging external fixation or plaster immobilization for treatment of a Colles’ type distal radial fracture. The Gartland and Werley score showed that most patients in each group had an excellent or good outcome and patient satisfaction was comparable and high in both groups. The fixator group had significantly less radial shortening ( P < 0.05 ). Despite a high level of radiographic malunion (50%) overall function, range of movement and activities of daily living were not limited. Twenty-five per cent of patients had minor radiological signs of post-traumatic arthritis although only one patient was symptomatic. We conclude that, in the long term, external fixation of distal radius fractures does not confer an improved outcome when compared to plaster immobilization.

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