Wrist arthrodesis.

Twenty consecutive patients were treated with wrist arthrodesis. Nine patients had rheumatoid arthritis, and eleven patients had a variety of other arthritic conditions. The average follow-up time was 34 months. Clinical examination and roentgenograms showed that eighteen patients had solid fusion of their wrists, with an average of 11 weeks of immobilization. Two patients had delayed union--one of them removed his cast after the operation. No reason for the delayed union was found in the second patient, who had rheumatoid disease. Ultimately, both patients had solid fusions after a total immobilization time of 20 weeks and 16 weeks, respectively. Solid fusion, pain relief, and satisfactory functional results can be achieved following wrist arthrodesis. Prerequisites for obtaining such results are as follows: First preoperative assessment of the patient's upper extremity level of function and range of motion (ROM) of all other joints of the extremity, and radiographic assessment of wrist and hand deformities. Second, during surgery, rigid fixation should be obtained and wrist deformity if present, as in rheumatoid disease, should be corrected. Third, a postoperative rehabilitation program should include range of motion of other joints, muscle strengthening, and functional activities.