Reiser Daniel, Hedspång Mattias, Sagerfors Marcus
Department of Orthopedics and Hand Surgery, Faculty of Medicine and Health, Örebro University, Södra Grev Rosengatan, 701 85 Örebro, Sweden.
JPRAS Open. 2025 Aug 21;46:54-60. doi: 10.1016/j.jpra.2025.08.016. eCollection 2025 Dec.
Salvage radiocarpal arthrodesis is an option in the treatment of failed wrist arthroplasty. If bony union is achieved the results can be comparable to primary wrist arthrodesis. Substantial bone loss and decreased vascularity of the bone may be an issue in some cases. The present case report describes the case of a 58-year-old man with posttraumatic wrist arthritis after an intraarticular distal radius fracture. He was treated with a wrist hemiarthroplasty which ultimately failed and was converted to a radiocarpal arthrodesis. After two failed arthrodeses with bone grafting and a dorsal locking plate, we performed a free vascularized fibula transfer which resulted in bony union and a pain-free wrist. Free vascularized fibula transfer may be a salvage option in select cases of failed radiocarpal arthrodesis.
挽救性桡腕关节融合术是治疗腕关节置换失败的一种选择。如果实现了骨性愈合，其结果可与初次腕关节融合术相媲美。在某些情况下，大量骨质流失和骨血管减少可能是一个问题。本病例报告描述了一名58岁男性，在桡骨远端关节内骨折后发生创伤后腕关节炎。他接受了腕半关节置换术，但最终失败，随后转为桡腕关节融合术。在两次采用植骨和背侧锁定钢板的关节融合术失败后，我们进行了游离血管化腓骨移植，结果实现了骨性愈合且腕部无痛。游离血管化腓骨移植可能是桡腕关节融合术失败的特定病例中的一种挽救选择。
