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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2023; 51(01): e041-e047
DOI: 10.1055/s-0043-1769604
Original Article

Total wrist Arthrodesis Using a Low-Profile, Variable-Angled Locked Dorsal Plate: Consolidation Rate and Complications of 85 Consecutive Cases

Article in several languages: español | English
Eduardo Farias Vasquez
1   Departamento de Cirugía de la Mano, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad (INTO), Rio de Janeiro, RJ, Brazil
2   Departamento de Ortopedia, Hospital São Vicente de Paulo, Rio de Janeiro, RJ, Brazil
,
Pedro Henrique Martinez Grosse Siestrup
1   Departamento de Cirugía de la Mano, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad (INTO), Rio de Janeiro, RJ, Brazil
,
Giovanni Vilardo Cerqueira Guedes 
1   Departamento de Cirugía de la Mano, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad (INTO), Rio de Janeiro, RJ, Brazil
2   Departamento de Ortopedia, Hospital São Vicente de Paulo, Rio de Janeiro, RJ, Brazil
,
Rafael Sousa Lima Barbosa
1   Departamento de Cirugía de la Mano, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad (INTO), Rio de Janeiro, RJ, Brazil
,
Anderson Vieira Monteiro
1   Departamento de Cirugía de la Mano, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad (INTO), Rio de Janeiro, RJ, Brazil
,
Arnaldo Couto
1   Departamento de Cirugía de la Mano, Instituto Nacional de Traumatologia e Ortopedia Jamil Haddad (INTO), Rio de Janeiro, RJ, Brazil
3   Departamento de Farmacia, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Brasil
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Funding Statement The author(s) received no financial support for the research, authorship, and/or publication of this article.
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Abstract

Introduction Wrist arthrodesis has evolved over time with the growing use of a more rigid implant, and a resultant increase in healing rates. However, complications such as irritation of the extensor tendons have led to the development and introduction of improved low-profile implants in recent years. This study aimed to examine the factors that influence the healing of total wrist arthrodesis and the frequency of complications using a low-profile plate from the same manufacturer.

Materials and Methods This is a retrospective study analyzing the medical records and radiographs of patients who underwent wrist arthrodesis using a long or short Aptus ® 2.5 Trilock Wrist Fusion Plate (Medartis AG, Basel, Switzerland) between 2015 2021 in a single hospital. Epidemiological and clinical variables were analyzed. The Chi-square test or Fischer's Exact Test was used to compare proportions and the results, with a p-value ≤ 0.05 being considered statistically significant.

Results Of the 85 wrist arthrodesis performed, 100% consolidation was observed in an average of 4.6 months after surgery. Most patients were non-smokers (80%) men (69.4%) with a mean age of 50.7 years. The complication rate was 10,5%, all of which were resolved after a further intervention, requiring only one implant removal. The mean time of consolidation in smokers was 5.8 months and in non-smokers 4.2 months (p = 0.03). The mean time of consolidation following the long plate procedures was slightly shorter than with the use of the short plate but was without statistical significance.

Conclusion The wrist arthrodesis in the present study had a consolidation rate of 100% with a low rate of complications and without differences in results regarding graft placement, carpometacarpal joint fusion, or the demographic profiles of the patients. Smoking was associated with increased consolidation time but did not lead to nonunion.

Level of evidence IV

Keywords

wrist arthrodesis - wrist fusion - plate - consolidation rate - complications

Ethical Approval Declaration

Ethical approval to report this case was obtained from ETHICS COMMITTEE of INSTITUTO NACIONAL DE TRAUMATOLOGIA E ORTOPEDIA JAMIL HADDAD (INTO).


Informed Consent Declaration

Dismissal of free and informed consent was made.


Contributorship Details

Giovanni Guedes, Pedro Siestrup, and Rafael Barbosa wrote the first draft of the manuscript. All authors reviewed and edited the manuscript and approved the final version of the manuscript.




Publication History

Received: 09 January 2023

Accepted: 04 May 2023

Article published online:
07 June 2023

© 2023. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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