Clinical Outcomes of Arthrodesis and Arthroplasty for the Treatment of Posttraumatic Wrist Arthritis

Purpose To compare clinical outcomes of wrist arthrodesis and total wrist arthroplasty in the treatment of pancarpal posttraumatic arthritis. We hypothesized that arthroplasty would demonstrate better clinical outcomes than wrist arthrodesis. Methods We performed a retrospective review of 22 patients treated (15 arthrodeses and 7 arthroplasties) for pancarpal posttraumatic arthritis. We measured clinical outcomes with the visual analog pain scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; the Patient-Rated Wrist Evaluation; and a study-specific questionnaire. Postoperative complications were recorded from chart review. Results Mean follow-up was 68 months for arthrodesis and 56 months for arthroplasty. The mean visual analog scale pain score was 2 for each group. The mean Disabilities of the Arm, Shoulder, and Hand score was 38 for the arthrodesis group and 29 for the arthroplasty group. The mean Patient-Rated Wrist Evaluation was 73 for the arthrodesis group and 31 for the arthroplasty group. The results from the study-specific questionnaire revealed that the majority of patients in both groups were satisfied. Complication rates were similar in both groups. Conclusions Total wrist arthroplasty as an alternative to arthrodesis for the treatment of pancarpal posttraumatic arthritis may offer improved functional outcomes. (Copyright (C) 2013 by the American Society for Surgery of the Hand. All rights reserved.)