期刊
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
卷 46, 期 3, 页码 200-208出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jhsa.2020.09.019
关键词
Nonunion; proximal row carpectomy; radiocarpal fusion; wrist fusion
Wrist fusion provides a solution to painful and arthritic wrists, with the additional benefit of combining it with a PRC for potentially higher fusion rates. However, the study results show that the presence or absence of PRC does not significantly impact the union rate of wrist fusion.
Purpose Wrist fusion provides a solution to the painful, arthritic wrist, and can be concomitantly performed with or without a proximal row carpectomy (PRC). The benefits of combining a PRC with fusion include a large amount of local bone graft for fusion and a lower number of joints needed to fuse. We hypothesized that wrist fusion combined with PRC will have a higher fusion rate than wrist fusion performed without PRC. Methods A systematic review was performed to identify all papers involving wrist arthrodesis using the following databases: PubMed, Ovid, Scopus, Web of Science, and COCHRANE. A literature search was performed using the phrases wrist OR radiocarpal and fusion OR arthrodesis. Inclusion criteria included complete radiocarpal fusion performed for rheumatoid, posttraumatic, or primary arthritis; union rates available; English-language study. Studies were excluded if case reports; diagnoses other than the ones listed previously; inability to abstract the data. Data collected included wrist fusions with PRC or without PRC, union rate, patient age, underlying diagnosis, and method of fixation. Results A total of 50 studies were included in the analysis. There were 41 studies with no PRC, 8 studies with PRC, and 1 study with and without PRC. There were 347 patients with a PRC and 339 patients had a successfully fused wrist (97.7%). There were 1,355 patients who had a wrist fusion with no PRC, and1,303 patients had successful wrist fusion (96.2%). The difference in fusion rate between the 2 groups, 97.7% versus 96.2%, was not statistically significant. Conclusions There is no statistically significant difference with regards to union rate in wrist fusion with a PRC versus wrist fusion without a PRC. Copyright (C) 2021 by the American Society for Surgery of the Hand. All rights reserved.
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