Radioscapholunate Arthrodesis and Distal Radioulnar Joint Arthroplasty for Rheumatoid Wrist Arthritis: A Surgical Technique

We describe the treatment of rheumatoid radiocarpal joint and distal radioulnar joint (DRUJ) arthritis with radioscapholunate (RSL) arthrodesis and DRUJ arthroplasty in 2 patients with 2 years follow-up. The RSL arthrodesis utilizes nitinol staples and local distal radius autograft to fuse the scaphoid and lunate to the distal radius. Materials and Methods: One patient was treated in their nondominant extremity, and the other patient had bilateral procedures. A constrained endoprosthesis was used for the DRUJ arthroplasty portion, using the same dorsal approach to the wrist as the RSL arthrodesis. Results: Before his procedures, this first patient-reported a Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score of 66, which improved to 16 at 2 years postoperatively. He also reported a Visual Analog Scale score of 6/10 at rest in both wrists preoperatively. Following his procedures, Visual Analog Scale scores improved to 3/10 in the right wrist and 0/10 in the left wrist. Active wrist range of motion was measured to be a 60-degree arc on the right and a 47-degree arc on the left. Our second patient reported an improved QuickDASH score from 97 preoperatively to 68 at 2 years postoperatively and had a 70-degree arc of left wrist range of motion. No postoperative complications or reoperations were encountered in the cases. Discussion: The benefit of this technique is to allow simultaneous treatment of radiocarpal joint arthritis with RSL arthrod...
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Special Technical Articles Source Type: research