• K Trieb, P Machacek, S G Hofstaetter, J Panotopoulos, and A Wanivenhaus.
• Department of Orthopaedics, Klinikum Wels-Grieskirchen, Grieskirchnerstrassse 42, Wels, Austria. Klemens.trieb@klinikum-wegr.at
• Arch Orthop Trauma Surg. 2013 May 1;133(5):729-34.

Background And PurposeThe wrist is one of the most affected joints in rheumatoid arthritis. The purpose of this retrospective study was to assess clinical, functional and radiographic results of radio-lunate arthrodesis. Two different operation and fixation techniques are compared and detailed outcome after this intervention is presented.MethodsTwenty-seven patients with long-standing rheumatoid arthritis were operated on, either by stabilisation of the arthrodesis with Shapiro staples (n = 14) or by Herbert screw (n = 13) and followed for a mean of 5.4 years.ResultsRadio-lunate arthrodesis resulted in high overall and subjective satisfaction concerning function, grip and return to work. Grip strength was 35 kPa for the dominant and 26 kPa for the non-dominant hand. No revision, pseudoarthrosis or hardware failure was observed; only two conservatively treated wound healing problems were reported. The procedure resulted in a mean flexion of 26° and a mean extension of 24°; a clear improvement was also seen in activities of daily life. No difference between both groups was observed for pain, complication rate or functional outcome.InterpretationDue to high patient satisfaction and functional outcome, radio-lunate wrist arthrodesis can be recommended independent of fixation method.

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