Arthroscopic-assisted total wrist arthrodesis: surgical design and clinical outcomes

Fengchi Sun; Yuchen  Liu; Shuai Zhu; Xiangmeng Su; Siwei Xu; Huawei Yin; Wendong Xu; Yundong Shen

doi:10.2340/jphs.v60.42751

Authors

Fengchi Sun Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing’an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China
Yuchen Liu Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing’an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China
Shuai Zhu Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing’an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China
Xiangmeng Su Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing’an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China
Siwei Xu Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing’an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China
Huawei Yin Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing’an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China
Wendong Xu Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing’an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China
Yundong Shen Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing’an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China

DOI:

https://doi.org/10.2340/jphs.v60.42751

Keywords:

Wrist arthritis, total wrist arthrodesis, wrist fusion, wrist arthroscopy, minimal invasive

Abstract

Introduction: This study presents an innovative arthroscopy-assisted total wrist arthrodesis technique utilising three hollow screws, aimed at improving clinical outcomes for patients with severe wrist arthritis.

Materials and methods: The technique involved the placement of three hollow screws to facilitate wrist bone fusion. Between August 2019 and August 2023, four patients diagnosed with severe wrist arthritis underwent the arthroscopy-assisted procedure. Each patient was followed postoperatively for at least 1 year. Clinical evaluations included the Visual Analogue Scale (VAS), the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire, and the Patient-Rated Wrist Evaluation (PRWE). Radiographic imaging was performed to confirm successful bone fusion. Postoperative complications and scar length were also recorded.

Results: At the final follow-up, all patients exhibited decreased scores on the VAS, Quick DASH, and PRWE assessments, indicating reduced pain and improved wrist function. Radiographic imaging confirmed successful wrist bone fusion. No major complications arose, with an average scar length of 2.8 cm.

Conclusion: The novel arthroscopy-assisted total wrist arthrodesis technique offers a simple and minimally invasive method that effectively improves joint function and alleviates pain in patients with severe wrist arthritis, while reducing the risk of complications.

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