Abstract
Purpose of the study is to evaluate the results and experience with total wrist replacement with a cementless prosthesis of our own design. A group of 55 women and 9 men treated between 2005 and 2012 was evaluated.
Main indication for surgery was wrist destruction due to rheumatoid arthritis. From objective point of view we assess range of motion and radiographic documentation.
All patients reported pain relief, 43 were satisfied with wrist mobility and hand appearance. 17 patients were only partly satisfied and would have preferred a greater range of motion. Four patients were dissatisfied with an ulnar deviation of the carpal axis.
We have encountered migration of metacarpal stem or antirotation pin with its fracture in four cases, followed by head luxation in two of them. Total wrist replacement is usually preceded by surgeries that intend to prevent or slow down gradual wrist destruction.
For the most severe destruction associated with subluxation and wrist instability, total arthrodesis in a neutral wrist position still remains the method of choice.