Arthrodesis of Wrist Joint Locking Plate: A Comprehensive Guide

Arthrodesis of the wrist joint is a surgical procedure that aims to fuse the bones of the wrist together, eliminating joint movement and reducing pain. Wrist arthrodesis is often performed in patients with severe wrist arthritis, traumatic injuries, or failed wrist surgeries. In this article, we will discuss the use of locking plates in wrist arthrodesis, the procedure itself, the recovery process, and potential complications.

Understanding Wrist Arthrodesis

What is Wrist Arthrodesis?

Wrist arthrodesis is a surgical procedure that involves fusing the bones of the wrist joint together. The aim of the procedure is to eliminate joint movement and reduce pain. Arthrodesis can be performed on any of the wrist joints, including the radiocarpal, intercarpal, and carpometacarpal joints.

Why is Wrist Arthrodesis Performed?

Wrist arthrodesis is typically performed in patients with severe wrist arthritis, traumatic injuries, or failed wrist surgeries. Arthrodesis may also be recommended for patients with certain congenital conditions, such as Madelung's deformity or Kienbock's disease.

What are the Benefits of Wrist Arthrodesis?

The main benefit of wrist arthrodesis is pain reduction. By fusing the bones together, the joint is stabilized and pain is reduced. Arthrodesis can also improve grip strength and wrist function in some cases.

What are the Risks of Wrist Arthrodesis?

The main risks of wrist arthrodesis are non-union (where the bones fail to fuse together), malunion (where the bones fuse in a suboptimal position), and infection. In addition, wrist arthrodesis may limit wrist range of motion and affect overall hand function.

The Use of Locking Plates in Wrist Arthrodesis

What are Locking Plates?

Locking plates are orthopedic implants used to stabilize bones during fracture healing or joint fusion. Locking plates have a special screw design that allows them to engage with the bone in a way that traditional plates do not.

Why are Locking Plates Used in Wrist Arthrodesis?

Locking plates are often used in wrist arthrodesis because they provide superior stability compared to traditional plates. This is especially important in patients with poor bone quality, as locking plates can achieve fixation in these cases where traditional plates cannot.

How are Locking Plates Used in Wrist Arthrodesis?

During wrist arthrodesis surgery, the bones of the wrist are prepared for fusion. Once the bones are properly aligned, a locking plate is positioned over the bone and screwed into place. The screws used in locking plate fixation are designed to engage with the bone in a way that traditional screws cannot.

What are the Advantages of Using Locking Plates in Wrist Arthrodesis?

The use of locking plates in wrist arthrodesis has several advantages, including increased stability, reduced risk of screw loosening, and the ability to achieve fixation in cases of poor bone quality.

The Wrist Arthrodesis Procedure

Preoperative Planning

Before wrist arthrodesis surgery, your surgeon will perform a thorough evaluation of your wrist and overall health. This may include X-rays, CT scans, or MRI scans to assess the extent of your wrist arthritis or other conditions.

Anesthesia

Wrist arthrodesis surgery is typically performed under general anesthesia. In some cases, local anesthesia with sedation may be used.

Incision and Exposure

The surgeon will make an incision over the wrist to expose the bones. The skin and soft tissues are carefully dissected to access the wrist joint.

Bone Preparation

The bones of the wrist joint are prepared for fusion by removing the cartilage and shaping the bones to fit together properly. The surgeon may use bone grafts to aid in the fusion process.

Plate Placement and Fixation

Once the bones are prepared, the locking plate is positioned over the bone and screwed into place. The screws used in locking plate fixation are designed to engage with the bone in a way that traditional screws cannot.

Closure

Once the plate and screws are in place, the incision is closed with sutures or staples. A cast or splint may be applied to the wrist to aid in the healing process.

Recovery Process

Postoperative Care

After wrist arthrodesis surgery, you will be closely monitored in the hospital for any signs of complications. You may be given pain medication and antibiotics to prevent infection.

Immobilization

The wrist will be immobilized in a cast or splint for several weeks to allow for proper healing. Physical therapy may be recommended to aid in recovery.

Return to Normal Activities

Most patients can expect to return to normal activities within three to six months after surgery. However, it may take up to a year for the bone to fully fuse together and for the wrist to fully heal.

Potential Complications

Non-Union

Non-union is a potential complication of wrist arthrodesis, where the bones fail to fuse together properly. This may require additional surgery to correct.

Malunion

Malunion is a potential complication of wrist arthrodesis, where the bones fuse in a suboptimal position. This may result in decreased wrist function or pain.

Infection

Infection is a potential complication of any surgical procedure. Signs of infection include redness, swelling, fever, and increased pain.

Conclusion

Wrist arthrodesis is a surgical procedure that aims to fuse the bones of the wrist together, reducing pain and improving wrist function. The use of locking plates in wrist arthrodesis provides superior stability compared to traditional plates, making it an attractive option for patients with poor bone quality. However, as with any surgical procedure, there are potential risks and complications that should be discussed with your surgeon.