Ulnocarpal epiphyseal arthrodesis for recurrent deformity after centralization for radial longitudinal deficiency

Jeffrey M. Pike, Paul R. Manske, Jennifer A. Steffen, Charles A. Goldfarb

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12 Scopus citations

Abstract

Purpose To report our results for ulnocarpal epiphyseal arthrodesis for recurrent or late-presenting wrist deformity in patients with radial longitudinal deficiency, using both objective data and long-term subjective follow-up evaluation. Methods A retrospective review of our surgical logs between 1970 and 2007 identified 12 postcentralization patients treated with ulnocarpal epiphyseal arthrodesis, and 1 patient (who had reached skeletal maturity) treated with traditional ulnocarpal arthrodesis. Indications for the arthrodesis included postcentralization recurrence of radial angulation to greater than 45°, an inability to actively extend the wrist to within 25° of neutral (ie, 25° of flexion), or both. We collected objective and radiographic data on all 12 patients by chart review at a mean of 89 months (range, 2472 mo) after arthrodesis. We collected subjective data from 9 patients at a mean of 160 months (range, 14602 mo) after arthrodesis. Results Ulnocarpal union was obtained in 11 wrists at an average of 4 months (range, 26 mo); the 1 case of nonunion was treated successfully with revision arthrodesis. The mean radial angulation position was 20° after arthrodesis (range, 0° to 35°), an average improvement of 42°. The mean position of wrist fusion was 11° of flexion (range, 0° to 35° of flexion), an average improvement of 7°. The mean postoperative Disabilities of the Arm, Shoulder, and Hand score was 24.5 (SD, 12.3; range, 6.836.4). Final postoperative Visual Analog Score rating for function averaged 8 (range, 410); for appearance, it averaged 7 (range, 510), and for pain, it averaged 1 (range, 05). Conclusions Ulnocarpal and epiphyseal arthrodesis are appropriate surgical procedures to stabilize the carpus in postcentralization patients with recurrent or late-presenting wrist deformity.

Original languageEnglish
Pages (from-to)1755-1761
Number of pages7
JournalJournal of Hand Surgery
Volume35
Issue number11
DOIs
StatePublished - Nov 2010

Keywords

  • Arthrodesis
  • club hand
  • fusion
  • radial longitudinal deficiency
  • recurrent

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