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Minerva Orthopedics 2021 April;72(2):165-80

DOI: 10.23736/S2784-8469.21.04072-8


language: English

Degenerative sequelae in wrist trauma: surgical options

Simona ODELLA 1 , Francesco LOCATELLI 1, Elia CRETA 1, Jacopo FLORE 1, Alessandro CROSIO 1, Alessandra FIN 1, Michele D. LOMBARDO 1, 2, Pierluigi TOS 1

1 Unit of Hand Surgery and Microsurgery, ASST Pini CTO, Milan, Italy; 2 Residency Program in Orthopedics and Traumatology, University of Milan, Milan, Italy

INTRODUCTION: As a result of wrist trauma there are many possibilities to develop post-traumatic osteoarthritis: both because of fractures and of untreated ligament injuries. The review below shows the causes of trauma-related osteoarthritis and surgical options so far known in the literature.
EVIDENCE ACQUISITION: An extensive research has been performed on Medline with the following phraseology: “wrist arthritis AND distal radius fractures AND/OR perilunate dislocations and/or scaphoid nonunion and/or lunate dislocation” limited to systematic reviews and randomized controlled trials, to consider only studies with high statistical power. The resulting papers were screened by title and abstract and further papers were retrieved by the reference list of each article.
EVIDENCE SYNTHESIS: The aim of surgical treatment is to remove the pain while maintaining a range of motion; when preserving a complete range of motion is not possible, partial or total arthrodesis of the wrist could be a solution. Different partial wrist fusions have been proposed, depending on the joint affected by arthritis. In case of osteoarthritis of the radio-lunate joint, if midcarpal joint is preserved, an alternative solution could be the resection of the first carpal row. Wrist prostheses can certainly be a solution in patients who do not want fusion and do not need strength; they should be aware of the possible need for further surgical treatment.
CONCLUSIONS: Wrist post-traumatic arthritis can benefit of different surgical procedures, the choice is related on the stage and the anatomical location of the degeneration, considering patient’s functional needs.

KEY WORDS: Wrist; Ligaments; Arthritis; Fractures, bones

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