Canis ISSN: 2398-2942

Arthrodesis: partial carpal

Introduction

  • To fuse the middle carpal and carpometacarpal joints, sparing the antebrachial joint, using internal fixation, thereby preventing painful movement.
  • Treatment of choice: K-wires.
  • See arthrodesis overview Arthrodesis: overview for more detail.

Uses

  • Same as pancarpal arthrodesis Arthrodesis: pancarpal.
    Partial carpal arthrodesis is contraindicated when the antebrachiocarpal joint or its ligaments are affected.
  • Assessment of such damage requires stress radiography.
    If in doubt perform a pancarpal arthrodesis Arthrodesis: pancarpal.

Advantages

  • The presence of infection does not obviate the use of this technique.
    Infection must be controlled in conjunction with surgery.
  • Open injuries with extensive bone and soft tissue loss can be managed after arthrodesis with the use of external fixators Fracture fixation: external skeletal fixator.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Generally good prognosis (70% normal limb function).
  • Approximately half normal range of movement in the carpus.
  • Good prognosis for bilateral condition.
  • DJD of antebrachial joint may be a sequela (15%) → secondary to abnormal stresses on joint following partial arthrodesis or undiagnosed ligamentous injuries.

Further Reading

Publications

Refereed papers


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