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Bozon O, Chammas M, Degeorge B, et al. Wrist shortening arthrodesis with volar plate in a dorsal position for spastic wrist contracture. Hand Surg Rehabil. 2021;doi: 10.1016/j.hansur.2021.10.313.
Bozon, O., Chammas, M., Degeorge, B., Coroian, F., Lafont, I., & Coulet, B. (2021). Wrist shortening arthrodesis with volar plate in a dorsal position for spastic wrist contracture. Hand surgery & rehabilitation, . https://doi.org/10.1016/j.hansur.2021.10.313
Bozon, O, et al. "Wrist shortening arthrodesis with volar plate in a dorsal position for spastic wrist contracture." Hand surgery & rehabilitation vol. (2021). doi: https://doi.org/10.1016/j.hansur.2021.10.313
Bozon O, Chammas M, Degeorge B, Coroian F, Lafont I, Coulet B. Wrist shortening arthrodesis with volar plate in a dorsal position for spastic wrist contracture. Hand Surg Rehabil. 2021 Oct 22; doi: 10.1016/j.hansur.2021.10.313. Epub 2021 Oct 22. PMID: 34688950.
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Hand Surg Rehabil. 2021 Oct 22; doi: 10.1016/j.hansur.2021.10.313. Epub 2021 Oct 22.

Wrist shortening arthrodesis with volar plate in a dorsal position for spastic wrist contracture.

Hand surgery & rehabilitation

O Bozon, M Chammas, B Degeorge, F Coroian, I Lafont, B Coulet

Affiliations

  1. Département de chirurgie orthopédique, unité de chirurgie du membre supérieur, de la main et des nerfs périphériques, CHU Lapeyronie, 191 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France. Electronic address: [email protected].
  2. Département de chirurgie orthopédique, unité de chirurgie du membre supérieur, de la main et des nerfs périphériques, CHU Lapeyronie, 191 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France.
  3. Service de médecine physique et réadaptation, CHU Lapeyronie, 191 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France; Institut de Neuro-Orthopédie Montpellier INOM, CHU Lapeyronie, 191 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France.
  4. Département de chirurgie orthopédique, unité de chirurgie du membre supérieur, de la main et des nerfs périphériques, CHU Lapeyronie, 191 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France; Institut de Neuro-Orthopédie Montpellier INOM, CHU Lapeyronie, 191 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France.

PMID: 34688950 DOI: 10.1016/j.hansur.2021.10.313

Abstract

Total wrist arthrodesis in severe wrist flexion deformities (greater than 60°) due to spasticity represents a valid therapeutic option. It aims to improve the hand's appearance, hygiene, function and to prevent the deformity from getting worse. The objective of this study is to evaluate the clinical and anatomical results of wrist shortening arthrodesis using a classic volar plate in the dorsal position in functional surgery for central spastic hands. We conducted a single-center analysis of a series of patients who underwent this shortening arthrodesis. The review at a minimum 1-year follow-up included a clinical evaluation (House score, INOM score, patient satisfaction and complications), and anatomical evaluation (arthrodesis position, bone healing and carpometacarpal arthropathy). Twenty-eight patients with a mean age of 40.6 years (18-74) were included at a mean follow-up of 30.6 months (12-75). The fusion rate was 100%. No carpometacarpal arthropathy was noted. The mean position of the fused wrist was 11° extension and 15° ulnar tilt. There were two complications (7%): one postoperative hematoma and one case of discomfort due to impingement that required plate removal. The House score was significantly improved postoperatively (2.4 (0-5) versus 1.8 (0-4), p < 0.001), as was the INOM score (45 (12-64) versus 63 (36-84), p < 0.001). The patient satisfaction rate was 93%. The use of a simple and common material (volar plate in dorsal position) during this challenging surgery (spastic wrist contracture), provides good anatomical results and high patient satisfaction. LEVEL OF EVIDENCE: Level 4, case series, therapeutic study.

Copyright © 2021. Published by Elsevier Masson SAS.

Keywords: Arthrodèse du poignet; Plaque palmaire; Poignet spastique; Raccourcissement; Shortening; Spastic wrist; Volar plate; Wrist arthrodesis

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