Situación de salud después de la artrodesis total de muñeca … (Inglés)

Lauren Adey MDa, b, David Ring MDa, b, , and Jesse B. Jupiter MDa, b

aHand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA bHarvard Medical School, Boston, MA

Purpose Total wrist arthrodesis is regarded as the most predictable way to relieve the pain of posttraumatic wrist arthritis. Wrist arthrodesis also is believed to be compatible with a high level of upper-extremity function. This study evaluated the effect of total wrist arthrodesis on both general and upper-extremity–specific health status in patients treated for posttraumatic wrist arthritis.

Methods By using an institutional review board–approved protocol 22 patients were evaluated an average of 6 years after total wrist arthrodesis for posttraumatic arthritis. Upper-extremity–specific and general health status were measured using the Disabilities of the Arm, Shoulder, and Hand questionnaire and the Short-Form 36 (SF-36) instruments, respectively. Patient satisfaction and interest in pursuing a wrist-mobilizing procedure should one become available also were assessed. Objective assessment included grip strength, digit range of motion, and radiographic fusion.

Results Grip strength averaged 79% of the uninvolved wrist. The average Disabilities of the Arm, Shoulder, and Hand questionnaire score was 25. The average physical component score of the Short-Form 36 was 39 and the average mental component score was 52. Fourteen patients complained of wrist pain, including severe pain in 4 patients. Fifteen patients were satisfied or very satisfied with the result of the fusion, 5 patients were neutral, and 2 patients were mildly dissatisfied. Twenty patients would elect to have a procedure that could make their wrist move again if one were available.

Conclusions Substantial dysfunction was noted on both upper-extremity–specific and general health status measures after total wrist arthrodesis for posttraumatic conditions. Pain was improved but not eliminated.

The Journal of Hand Surgery Volume 30, Issue 5 , September 2005, Pages 932-936.