Clinical and radiographic study of partial arthrodesis for rheumatoid wrists. Issue 1 (2nd January 2016) - Saito, Taichi
Abstract : Objectives. To retrospectively investigate the clinical and radiographic results of partial arthrodesis for the wrists with rheumatoid arthritis (RA). Methods. Forty-one wrists with RA were treated by radiolunate (RL) or radiolunotriquetral (RLT) arthrodesis with ulnar head resection. The average follow-up period after surgery was 7.1 years. Preoperative radiographs of all wrists were classified according to Schulthess classification. We performed RL arthrodesis for all Type II ( n = 26) and Type III wrists ( n = 7), and RLT arthrodesis for Type III wrists ( n = 8). Pre- and postoperative pain score (visual analog scale), grip strength, range of motion, and radiographic parameters were statistically compared. Results. Pain scores in all groups were significantly improved at final follow-up ( P < 0.05). Grip strength increased from 5.9 to 12.4 (kg) significantly in Type II wrists ( P < 0.01), from 7.2 to 9.1 in Type III wrists after RLT arthrodesis, but decreased from 6.9 to 6.0 in Type III wrists after RL arthrodesis. In all groups, the arc of pronation and supination improved significantly ( P < 0.05), and all radiographic parameters improved. Conclusions. RL arthrodesis for Type II wrists showed satisfactory clinical results. RLT arthrodesis would be a reliable method in case of unstable wrist joint.