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J Wrist Surg 2022; 11(05): 395-405
DOI: 10.1055/s-0041-1740404
Scientific Article

Total Wrist Fusion with an Intramedullary Device: A Single-Institution Series with a Minimum of One Year Follow-Up

Richard Samade
1   Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
Andrew B. Campbell
1   Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
Hisham M. Awan
1   Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
,
Kanu S. Goyal
1   Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio
› Author Affiliations Funding None.
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Abstract

Objective The primary purpose of this study was to evaluate the functional and surgical outcomes of total wrist fusion (TWF) following the use of a locked intramedullary nail (IMN).

Methods A single institution study was performed, which entailed in-person reexamination of 18 patients (n = 19 wrists), out of 35 eligible patients, who underwent TWF with an IMN from 2010 to 2017. For each patient, demographic, preoperative diagnosis, physical examination, wrist radiograph, and outcome questionnaire data were obtained. The questionnaires included the visual analog scale (VAS), quick disabilities of the arm, shoulder, and hand (QuickDASH), and Mayo Wrist Score assessments. In addition, complication and reoperation data for all TWFs with an IMN during the 2010 to 2017 period (35 patients, n I = 38 wrists) were noted.

Results In the 18 patients, age was 47.6 ± 13.9 years, 12 (63.2%) were female, and median follow-up was 150 weeks (range: 74–294). The VAS score was 0 ± 0 in 5 of 19 wrists with rheumatoid arthritis (RA) and 1.82 ± 2.78 in 14 of 19 wrists without RA. It was found that 21 of 38 wrists (55.3%) had an implant-related complication and 5 wrists (13%) underwent a reoperation due to the implant itself.

Conclusions To date, no sufficient data are present demonstrating a clear advantage of an IMN over dorsal plating for TWF at intermediate-term follow-up. Surgeons should be knowledgeable of the several potential complications of this IMN prior to its use for TWF.

Level of Evidence This is a Level IV, therapeutic study.

Keywords

intramedullary nail - fusion - rheumatoid arthritis - total wrist fusion

Ethical Approval

This study was approved by the Biomedical Institutional Review Board of The Ohio State University.




Publication History

Received: 29 June 2020

Accepted: 22 October 2021

Article published online:
06 January 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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