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Total Wrist Fusion

Surgeon-side topic for wrist fusion. Backed by 424 articles from the corpus, retrieved via combined MeSH + title-text matching.

Overview

Total wrist arthrodesis remains the gold standard for unstable, destroyed rheumatoid wrists [14]. In contrast, total wrist fusion is performed nearly five times more frequently than total wrist arthroplasty [1]. Despite reports of positive early outcomes for fourth-generation implants, total wrist arthroplasty usage has declined [12]. Short-term findings indicate that total wrist arthroplasty compares favorably with wrist fusion [1]. However, arthroplasty offers a more ambitious functional goal at the cost of greater complication risks in rheumatoid wrists [14]. Consequently, total wrist fusion should be reserved for exceptional circumstances [5].

The decision between total wrist arthroplasty and total wrist arthrodesis relies on technical experience with newer implants, the patient’s ability to adhere to strict activity limitations, and the willingness to accept higher complication rates and eventual implant failure in exchange for maintaining some wrist motion [52]. Both procedures are extremely cost-effective for rheumatoid arthritis [25]. Additionally, there is a low rate of conversion to total wrist arthrodesis following scaphoid excision and four-corner arthrodesis for advanced carpal collapse [16].

Salvage options exist for failed implants in either direction. Conversion to arthrodesis after failed wrist arthroplasty is safe, effective, versatile, and reliably improves wrist function over the failed arthroplasty [2, 3]. Wrist arthrodesis is a reasonable salvage option for failed wrist arthroplasty [19]. Conversely, conversion from total wrist arthrodesis to modern wrist arthroplasty is feasible, yielding good functional results, significant pain relief, and stable implants [6].

Anatomy & Pathophysiology

Osseous and Arthrodesis Outcomes

Arthrodesis of the carpal bones limits wrist motion in all patients [10], though arthrosis of the radiocarpal joint developed in only four wrists following this procedure [10]. No salvage procedure can restore entirely full wrist function [23], and surgical treatments for scapholunate advanced collapse wrists result in decreased wrist kinematic motion and functional performance compared with normal wrists [32]. Limited arthrodesis of the wrist provides a stable wrist with partially restored motion and limited pain [18], and may only compromise select wrist functions [21].

Kinematics and Biomechanics

The oblique plane of the dart-thrower’s motion is an important functional axis of the human wrist used during most activities of daily living [50]. A wide range of dart-throwing planes exists in the wrist [35], and measurement methods have revealed biases that provide data for estimating true range of wrist motion [33]. Radioscapholunate fusion exhibits biomechanical behavior most similar to the healthy wrist among three compared fusion types [20]. Simulated radiocarpal or proximal carpal fusion decreases range of motion compared with the intact wrist but does not significantly alter the principal direction of wrist motion along the dart-thrower’s motion path [43].

Midcarpal arthrodesis adversely affects dart-throwing motion compared with radiocarpal arthrodesis [35]. Intercarpal arthrodeses make constant radiocarpal and midcarpal congruence during radioulnar deviation impossible, a state that exists in normal wrists [38]. Simulated radioscapholunate fusion alters midcarpal and lunotriquetral kinematics, with increased rotations across these remaining joints potentially explaining midcarpal degeneration [47]. Four-corner arthrodesis causes a shift of the lunate centroid radially and dorsally, explained by changes in the lunate's motion pattern during radioulnar deviation and flexion-extension [41]. Complete covering of the capitate head by the lunate places the wrist in increased radial deviation compared with the anatomic posture in a cadaveric model of simulated four-corner arthrodesis [44].

Comparative Fusion Profiles

Four-Corner Arthrodesis: Requires larger peak tendon forces to achieve identical wrist motions compared with the intact wrist [51]. Differences in range of motion and grip strength between four-corner arthrodesis methods using differing osteosynthesis are unlikely to be clinically relevant [49].

Four-Bone Arthrodesis: Has significantly lower contact pressure, greater contact area, and equal contact translation compared with proximal row carpectomy [42].

Proximal Row Carpectomy: Requires smaller forces to achieve identical wrist motions compared with four-corner arthrodesis [51].

Surgical Approaches and Adjuncts

The lateral approach to wrist arthrodesis preserves the distal radio-ulnar joint, avoids scarring of the extensor mechanism, and maintains normal wrist appearance [46]. Extensor synovectomy and excision of the distal ulna in rheumatoid arthritis result in significant reduction in wrist pain but also a reduction of wrist flexion [48].

Classification

Frequency and Indication: Total wrist fusion is performed nearly 5 times more frequently than total wrist arthroplasty [1]. Despite this prevalence, total wrist fusion should only be used for exceptional circumstances [5].

Technique Selection: Controversy remains regarding the best fusion technique for wrist arthritis [7]. Radioscapholunate fusion shows the most biomechanically similar behaviour out of three fusion types compared with the healthy wrist [20]. The combination of triquetral and distal scaphoid pole excision after radioscapholunate fusion improves wrist motion to levels close to normal in a cadaver model [24]. Total wrist arthrodesis using bowed crossed K-wires resulted in bony union of 22 wrists in 20 patients with no major postoperative complications [13]. Locked intramedullary wrist arthrodesis yields acceptable fusion rates [27]. Four-corner arthrodesis using headless compression screws yields results comparable to or better than previously published techniques in terms of fusion rates, pain alleviation, grip strength, range of motion, Mayo wrist score, and Disabilities of the Arm, Shoulder, and Hand questionnaire score [55]. Midcarpal arthrodesis with complete scaphoid excision and interposition bone graft is a technique used for advanced carpal collapse (SNAC/SLAC wrist) [5].

Other Considerations: Wrist fusion in patients receiving double free muscle transfers for reconstruction following complete brachial plexus paralysis resulted in improved finger range of motion and overall hand function [4]. Conversion to arthrodesis after failed wrist arthroplasty reliably improves wrist function over failed wrist arthroplasty [2]. Conversion from total wrist arthrodesis to a modern wrist arthroplasty is feasible, yielding good functional results, significant pain relief, and stable implants [6]. Results between patients undergoing conversion of total wrist arthrodesis to salvage failed total wrist arthroplasty and those undergoing primary wrist arthrodesis were slightly in favour of patients with primary wrist arthrodesis [11].

Clinical Presentation

Total wrist arthrodesis provides reliable pain relief and good functional outcomes with high patient satisfaction, particularly for end-stage arthritis and as a salvage technique [22]. It remains the gold standard for unstable destroyed rheumatoid wrists [14]. In contrast, total wrist arthroplasty offers a more ambitious functional goal but carries greater complication risks in the treatment of unstable destroyed rheumatoid wrists [14]. Complication rates for total wrist arthroplasty were higher than for wrist fusion, with reports of radiological loosening and osteolysis [9].

Wrist fusion in patients receiving double free muscle transfers for reconstruction following complete brachial plexus paralysis resulted in improved finger range of motion and overall hand function [4]. Total wrist fusion should only be used for exceptional circumstances [5]. Awareness of complications associated with wrist arthrodesis is essential for appropriately counseling patients on different arthrodesis options and informing them on what to expect from the procedure [34].

Controversy remains regarding the optimal treatment for young patients and laborers with wrist arthritis [7]. Controversy remains regarding the best fusion technique for wrist arthritis [7]. Controversy remains regarding the role of arthroscopy in the treatment of wrist arthritis [7].

Investigations

Plain radiography: Total wrist fusion is performed nearly 5 times more frequently than total wrist arthroplasty [1]. Preoperative radiographs often underestimate degenerative changes at the radiolunate joint, as they did not correlate well with intraoperative findings in the assessment of proximal row carpectomy versus scaphoid excision and intercarpal arthrodesis [63]. Total wrist fusion should only be used for exceptional circumstances in the treatment of advanced carpal collapse (SNAC/SLAC wrist) [5].

MRI: MRI serves as an important adjunct in the diagnosis of wrist tuberculosis, offering insights into bone, joint, and soft tissue involvement not visible on plain radiographs [56].

Other Considerations: Controversy remains regarding the optimal treatment for young patients and laborers with wrist arthritis [7]. Controversy remains regarding the best fusion technique for wrist arthritis [7]. Controversy remains regarding the role of arthroscopy in the treatment of wrist arthritis [7].

Treatment

Non-Operative

Radiocarpal fusion is indicated for patients with isolated radiolunate or radioscapholunate arthritis who have failed non-surgical treatment [59]. In most scenarios, there is no single preferred option for wrist osteoarthritis [58]. Total wrist denervation is a reliable and reproducible surgical technique for pain relief and preservation of wrist function in painful osteoarthritis [61].

Operative

Indications: Total wrist arthrodesis remains the gold standard for unstable, destroyed rheumatoid wrists [14]. Total wrist fusion should only be used for exceptional circumstances [5]. Surgical options such as fusion or arthroplasty are selected based on the specific joint involved, patient demands, and the risk of complications [26]. Arthroplasty should be used as an alternative to arthrodesis in the treatment of posttraumatic wrist arthritis, given proper patient selection and indications [40].

Surgical Approach / Technique: Total wrist fusion is performed nearly 5 times more frequently than total wrist arthroplasty [1]. Controversy remains regarding the optimal treatment for young patients and laborers, the best fusion technique, and the role of arthroscopy [7]. Total wrist arthrodesis using bowed crossed K-wires resulted in bony union of 22 wrists in 20 patients with no major postoperative complications [13]. All patients in the closed group of rheumatoid wrist arthrodesis using a modified Stanley Steinmann pin felt completely satisfied with the operative results, having a stable wrist, increased strength, and less pain compared with the open fusion group [64]. Cerclage fusion technique for 4-corner arthrodesis demonstrated excellent alignment, fusion consolidation, and excellent pain relief at 4 to 5 months [67]. Limited arthrodesis of the wrist for treatment of giant cell tumor of the distal radius provided a stable wrist, partially restored wrist motion, and limited pain [18].

Implant Selection: Good and excellent clinical results in the majority of patients following radiolunate fusion do not depend on the fixation device [8]. It remains unknown which implant type is best for total wrist arthrodesis or if the carpometacarpal joint should be included [28]. A trial is underway to contribute to an improved understanding of optimal management of the carpometacarpal joint (CMCJ) in total wrist arthrodesis [15].

Pain Management: Ultrasound-guided selective distal blocks using a long-acting local anesthetic, combined with oral analgesics, were effective in a large majority of patients for analgesia without motor blockade after hand and wrist bone surgery [57].

Adjuncts: The combination of triquetral and distal scaphoid pole excision after radioscapholunate (RSL) fusion improves wrist motion to levels close to normal in a cadaver model [24].

Revision: Conversion to arthrodesis after failed wrist arthroplasty is worthwhile and reliably improves wrist function over failed wrist arthroplasty [2]. Conversion of a failed total wrist arthroplasty to a wrist arthrodesis is safe, effective, and versatile [3]. Wrist arthrodesis is a reasonable option for salvage of a failed wrist arthroplasty [19]. Conversion from total wrist arthrodesis to a modern wrist arthroplasty is feasible, yielding good functional results, significant pain relief, and stable implants [6].

Other Considerations: Short-term findings suggest that total wrist arthroplasty compares favorably with wrist fusion [1]. Total wrist arthroplasty offers a more ambitious functional goal with greater complication risks than total wrist arthrodesis in rheumatoid wrists [14]. Total wrist arthroplasty declined despite reports of positive early outcomes for fourth-generation implants [12]. Total wrist arthroplasty and total wrist arthrodesis are both extremely cost-effective procedures for rheumatoid arthritis [25]. Complications and reoperations occur frequently in total wrist arthrodesis for advanced osteoarthritis, most often due to incomplete bone fusion or hardware-related problems [28]. Wrist fusion in patients receiving double free muscle transfers resulted in improved finger range of motion and overall hand function [4]. Although wrist motion is limited in all patients, arthrosis of the radiocarpal joint developed in only four wrists following arthrodesis for Kienböck’s disease, painful ununited fractures, or old fracture-dislocations [10]. There is a low rate of conversion to total wrist arthrodesis following scaphoid excision and four-corner arthrodesis for advanced carpal collapse [16].

Complications

Total Wrist Arthroplasty vs. Fusion: Total wrist arthroplasty demonstrates higher complication rates than wrist fusion, with specific reports of radiological loosening and osteolysis [9]. In the ankle, total ankle arthroplasty similarly exhibits a higher overall complication rate and a higher reoperation rate for revision compared to ankle arthrodesis [75].

Total Wrist Arthrodesis: Complications and reoperations in total wrist arthrodesis occur frequently, most often due to incomplete bone fusion or hardware-related problems [28]. It remains unknown which implant type is best for total wrist arthrodesis or if the carpometacarpal joint should be included [28].

Salvage Procedures: Revision arthroplasty for salvage of primary wrist arthroplasties in rheumatoid patients may have complications and reoperations [68]. Arthrodesis for salvage of primary wrist arthroplasties may also have complications and reoperations [68].

Radioscapholunate Arthrodesis: A high rate of re-operation was observed in patients receiving radioscapholunate arthrodesis for scapholunate advanced collapse II arthritis [73]. The expected benefit of preserving the midcarpal joint was not observed in these patients [73].

Recovery

Total wrist arthrodesis provides reliable pain relief and good functional outcomes with high patient satisfaction, particularly for end-stage arthritis and as a salvage technique [22]. It remains the primary salvage solution for severe wartime wrist injuries, predictably restoring grip strength and reducing disability [54]. However, no salvage procedure can restore entirely full wrist function [23].

Rehabilitation protocol: Starting early range of motion after surgery enables patients to regain functional wrist and forearm range of motion earlier with fewer therapy visits required [45].

Functional milestones: Radiolunate and radioscapholunate arthrodeses yield good clinical results at long-term follow-up despite radiographic progression [30]. Functional results of 4-corner fusion for SLAC and SNAC wrist were good at long-term follow-up despite radiographic changes in the radiolunate joint in 73% of patients [31]. Arthrodesis of the carpal bones limits wrist motion in all patients, but radiocarpal joint arthrosis developed in only four wrists [10]. Wrist arthrodesis with excision of the proximal carpal bones using the AO/ASIF wrist fusion plate and local bone graft resulted in all patients achieving radiographic fusion with good or excellent clinical outcomes regarding current condition and improvement [17]. Limited arthrodesis of the wrist for treatment of giant cell tumor of the distal radius provided a stable wrist, partially restored wrist motion, and limited pain [18]. Wrist fusion in patients receiving double free muscle transfers resulted in improved finger range of motion and overall hand function [4].

Other Considerations: Conversion from total wrist arthrodesis to a modern wrist arthroplasty is feasible, yielding good functional results, significant pain relief, and stable implants [6]. Conversion to arthrodesis after failed wrist arthroplasty is worthwhile and reliably improves wrist function over failed wrist arthroplasty [2]. The technique for conversion of a failed total wrist arthroplasty to a wrist arthrodesis is safe, effective, and versatile [3]. The results between primary wrist arthrodesis and salvage of failed total wrist arthroplasty were slightly in favour of patients with a primary wrist arthrodesis [11].

Key Evidence

  • [L4] Although wrist fusion is performed nearly 5 times more frequently than total wrist arthroplasty, short-term findings suggest that total wrist arthroplasty compares favorably with wrist fusion. (10.1177/1558944716668846)
  • [L4] Conversion to arthrodesis after failed wrist arthroplasty is worthwhile and reliably improves wrist function over failed wrist arthroplasty. (10.1177/1753193416674929)
  • [L4] This technique for conversion of a failed total wrist arthroplasty to a wrist arthrodesis is safe, effective, and versatile. (10.1016/j.jhsa.2016.02.012)
  • [L4] Wrist fusion in patients receiving double free muscle transfers resulted in improved finger range of motion and overall hand function. (10.1016/j.jhsa.2011.10.003)
  • [L4] Total wrist fusion should only be used for exceptional circumstances. (10.1054/jhsb.2000.0434)
  • [L4] Conversion from total wrist arthrodesis to a modern wrist arthroplasty is feasible, yielding good functional results, significant pain relief, and stable implants. (10.1016/j.jhsa.2024.10.007)
  • [Commentary] Despite extensive investigations to optimize treatment algorithms and surgical techniques for wrist arthritis, controversy remains regarding the optimal treatment for young patients and laborers, the best fusion technique, and the role of arthroscopy. (10.1016/j.jhsa.2025.06.014)
  • [L4] Good and excellent clinical results in the majority of the patients following radiolunate fusion do not depend on the fixation device. (10.1177/1753193409342054)
  • [L3] Complication rates were higher than wrist fusion, with reports of radiological loosening and osteolysis. (10.1177/1753193414539796)
  • [L4] Although wrist motion is limited in all patients, arthrosis of the radiocarpal joint developed in only four wrists. (10.2106/00004623-196648040-00008)
  • [L3] The results between the two groups were slightly in favour of patients with a primary wrist arthrodesis. (10.1177/17531934211057389)
  • [L2] Total wrist arthroplasty declined despite reports of positive early outcomes for fourth-generation implants. (10.1016/j.jhsa.2023.11.009)
  • [L4] The technique resulted in bony union of 22 wrists in 20 patients with no major postoperative complications. (10.1054/jhsb.1999.0170)
  • [L5] Total wrist arthrodesis remains the gold standard for unstable destroyed rheumatoid wrists, but total wrist arthroplasty offers a more ambitious functional goal with greater complication risks. (10.1016/j.jhsa.2008.06.004)
  • [L2] This trial will contribute to an improved understanding of optimal management of the CMCJ in total wrist arthrodesis. (10.1186/s12891-021-04644-4)
  • [L4] There is a low rate of conversion to total wrist arthrodesis. (10.1016/j.jhsa.2010.01.025)
  • [L4] All patients achieved radiographic fusion with good or excellent clinical outcomes regarding current condition and improvement. (10.1054/jhsb.2000.0488)
  • [L4] This technique provided a stable wrist and partially restored wrist motion with limited pain. (10.1016/j.jhsa.2013.04.026)
  • [L4] Wrist arthrodesis is a reasonable option for salvage of a failed wrist arthroplasty. (10.1177/1753193410376283)
  • [L4] Our findings suggest that wrist arthrodesis may only compromise select wrist functions. (10.1177/1558944715626930)
  • [L4] Total wrist arthrodesis provides reliable pain relief and good functional outcomes with high patient satisfaction, particularly for end-stage arthritis and as a salvage technique. (10.5435/jaaos-d-15-00424)
  • [L4] No salvage procedure can restore entirely full wrist function. (10.1177/1753193419876063)
  • [L5] The combination of triquetral and distal scaphoid pole excision after RSL fusion improves wrist motion to levels close to normal in the cadaver model. (10.1016/j.jhsa.2009.02.007)
  • [L2] Total wrist arthroplasty and total wrist arthrodesis are both extremely cost-effective procedures. (10.1016/j.jhsa.2009.12.013)
  • [L5] Surgical options such as fusion or arthroplasty are selected based on the specific joint involved, patient demands, and the risk of complications. (10.1016/j.jht.2022.01.001)
  • [L4] The locked intramedullary wrist arthrodesis system yields acceptable fusion rates. (10.1016/j.jhsa.2020.11.015)
  • [L5] Complications and reoperations occur frequently, most often due to incomplete bone fusion or hardware-related problems, and it remains unknown which implant type is best or if the carpometacarpal joint should be included. (10.1177/17531934241295343)
  • [L4] Despite radiographic progression, radiolunate and radioscapholunate arthrodeses yield good clinical results at long-term follow-up. (10.1016/j.jhsa.2011.10.012)
  • [L4] Functional results were good at long-term follow-up despite radiographic changes in the radiolunate joint in 73% of patients. (10.1177/1558944716681949)
  • [L2] Both surgical groups demonstrated decreased wrist kinematic motion and functional performance compared with individuals with normal wrists. (10.1016/j.jhsa.2015.04.035)
  • [L4] The revealed biases can provide valuable data for estimating the true range of wrist motion. (10.1016/j.jhsg.2025.01.013)
  • [L4] Awareness of complications associated with wrist arthrodesis and how best to avoid them is essential for the treating physician to appropriately counsel patients on different arthrodesis options and to inform them on what to expect from the procedure. (10.1016/j.hcl.2009.11.003)
  • [L5] This report updates information on wrist dart-throwing motion based on recent research regarding its kinematics, kinetics, and clinical applications, noting that a wide range of DT planes exists and that midcarpal arthrodesis adversely affects DT motion compared with radiocarpal arthrodesis. (10.1016/j.jhsa.2014.02.035)
  • [L5] The study confirms that constant radiocarpal and midcarpal congruence during radioulnar deviation in normal wrists is no longer possible with intercarpal kinematic modifications after these arthrodeses. (10.1177/17531934231176004)
  • [L3] Arthroplasty should be used as an alternative to arthrodesis in the treatment of posttraumatic wrist arthritis, given the proper patient selection and indications. (10.1016/j.jhsa.2013.02.013)
  • [L4] Changes of the motion pattern of the lunate during radioulnar deviation and flexion-extension of the wrist after FCA can explain the shift of the centroid radially and dorsally. (10.1016/j.jhsa.2014.11.028)
  • [L5] The FBA wrist has significantly lower contact pressure, greater contact area, and equal contact translation compared with the PRC wrist. (10.1016/j.jhsa.2012.05.040)
  • [L5] Although both simulated fusion types decreased ROM compared with the intact wrist, the principal direction of wrist motion along the path of DTM was not significantly altered by simulated RCF or PCF. (10.1016/j.jhsa.2017.10.017)
  • [L5] In this cadaveric model, complete covering of the capitate head by the lunate placed the wrist in increased radial deviation compared with the anatomic posture. (10.1016/j.jhsa.2016.07.101)
  • [L3] Starting early ROM after surgery enables patients to regain functional wrist and forearm ROM earlier with fewer therapy visits required. (10.1016/j.jht.2009.06.003)
  • [L5] Simulated radioscapholunate fusion altered midcarpal and lunotriquetral kinematics, with increased rotations across these remaining joints potentially explaining midcarpal degeneration. (10.1016/j.jhsa.2007.12.013)
  • [L4] There is a significant reduction in wrist pain but a reduction of wrist flexion. (10.1016/j.jhsa.2010.04.034)
  • [L4] While there are some significant differences in range of motion and grip strength, these differences are unlikely to be clinically relevant. (10.1016/j.jhsa.2021.06.002)
  • [L4] The study demonstrates that the oblique plane of the dart thrower's motion is an important functional axis of the human wrist used during most activities of daily living. (10.1177/1753193412460149)
  • [L5] Larger peak tendon forces were required to achieve identical wrist motions with 4-corner arthrodesis compared with the intact wrist, while smaller forces were observed for PRC. (10.1016/j.jhsa.2013.01.033)
  • [L4] The decision between total wrist arthroplasty and total wrist arthrodesis is based on technical experience with newer implants, the patient's ability to adhere to strict activity limitations, and the willingness to accept the higher complication rate and eventual implant failure of arthroplasty in exchange for maintaining some wrist motion. (10.1016/j.jhsa.2011.01.033)
  • [L4] Total wrist arthrodesis remains the primary salvage solution for severe wartime wrist injuries, predictably restoring grip strength and reducing disability. (10.1177/17531934251337589)
  • [L4] The results were comparable to or better than previously published techniques in terms of fusion rates, alleviation of pain, grip strength, range of motion, Mayo wrist score, and Disabilities of the Arm, Shoulder, and Hand questionnaire score. (10.1016/j.jhsa.2011.12.022)
  • [L4] MRI can serve as an important adjunct in the diagnosis of wrist TB, offering valuable insights into bone, joint, and soft tissue involvement that may not be visible on plain radiographs. (10.1016/j.jhsa.2025.05.015)
  • [L4] After hand and wrist bone surgery, USG selective distal blocks using a long-acting local anesthetic, combined with oral analgesics, were effective in a large majority of patients. (10.1016/j.jhsa.2014.01.011)
  • [L5] Despite advancements in management, in most scenarios there is no single preferred option for wrist osteoarthritis. (10.1177/17531934241296758)
  • [L5] The procedure aims to alleviate pain and improve range of motion in patients with isolated radiolunate or radioscapholunate arthritis who have failed non-surgical treatment. (10.1016/j.jhsa.2022.04.002)
  • [Paper] Total wrist denervation is a reliable and reproducible surgical technique for pain relief and preservation of wrist function in painful osteoarthritis. (10.1016/j.otsr.2019.04.024)
  • [L4] Preoperative radiographs did not correlate well with intraoperative findings, often underestimating degenerative changes at the radiolunate joint. (10.1016/j.jhsa.2014.03.032)
  • [L4] All patients in the closed group felt completely satisfied with the operative results, having a stable wrist, increased strength with less pain when compared with the open fusion group. (10.1054/jhsb.1999.0289)
  • [L4] The case illustration demonstrated excellent alignment, fusion consolidation, and excellent pain relief at 4 to 5 months. (10.1016/j.jhsa.2019.02.016)
  • [L4] Revision arthroplasty may be a useful alternative to arthrodesis for the salvage of primary wrist arthroplasties in rheumatoid patients, but complications and reoperations may occur after both revision arthroplasty and arthrodesis. (10.1054/jhsb.2002.0812)
  • [L1] A high rate of re-operation was observed in patients receiving radioscapholunate arthrodesis, and the expected benefit of preserving the midcarpal joint was not observed. (10.1177/1753193418778471)
  • [L1] Pooled data analysis demonstrated a higher overall complication rate after AA, but a higher reoperation rate for revision after TAA. (10.1186/s13018-017-0576-1)

See Also

  • Wrist Osteoarthritis
  • SLAC and SNAC Wrist

References

[1] Total Wrist Arthroplasty Versus Wrist Fusion: Utilization and Complication Rates as Reported by ABOS Part II Candidates. HAND. 2016. DOI: 10.1177/1558944716668846

[2] Successful conversion of wrist prosthesis to arthrodesis in 11 patients. Journal of Hand Surgery (European Volume). 2016. DOI: 10.1177/1753193416674929

[3] Wrist Arthrodesis for Failed Total Wrist Arthroplasty. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2016.02.012

[4] Role of Wrist Arthrodesis in Patients Receiving Double Free Muscle Transfers for Reconstruction Following Complete Brachial Plexus Paralysis. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2011.10.003

[5] Midcarpal Arthrodesis with Complete Scaphoid Excision and Interposition Bone Graft in the Treatment of Advanced Carpal Collapse (SNAC/SLAC Wrist): Operative Technique and Outcome Assessment. Journal of Hand Surgery. 2000. DOI: 10.1054/jhsb.2000.0434

[6] Conversion of Total Wrist Arthrodesis to a Total Wrist Arthroplasty: Twelve Patients Followed for 7 (2–16) Years. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.10.007

[7] Commentary on “Motion-Preserving Procedures in the Treatment of Scapholunate Advanced Collapse Wrist”. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2025.06.014

[8] Radiolunate fusion in the rheumatoid wrist with Shapiro staples: clinical and radiological results of 22 cases. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193409342054

[9] Total wrist arthroplasty: a systematic review of the evidence from the last 5 years. Journal of Hand Surgery (European Volume). 2014. DOI: 10.1177/1753193414539796

[10] Arthrodesis of the Carpal Bones in the Treatment of Kienböckʼs Disease, Painful Ununited Fractures of the Navicular and Lunate Bones with Avascular Necrosis, and Old Fracture-Dislocations of Carpal Bones. The Journal of Bone & Joint Surgery. 1966. DOI: 10.2106/00004623-196648040-00008

[11] Comparative outcomes of total wrist arthrodesis for salvage of failed total wrist arthroplasty and primary wrist arthrodesis. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211057389

[12] A Changing Landscape in the Surgical Management of Wrist Arthritis: An Analysis of National Trends From 2009 to 2019. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.11.009

[13] Total Wrist Arthrodesis Using Bowed Crossed K-Wires. Journal of Hand Surgery. 1999. DOI: 10.1054/jhsb.1999.0170

[14] Management of Bilateral Advanced Rheumatoid Wrist Destruction. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2008.06.004

[15] Total wrist arthrodesis with and without arthrodesis of the carpoMetacarpal joint (WAWWAM): study protocol. BMC Musculoskeletal Disorders. 2021. DOI: 10.1186/s12891-021-04644-4

[16] The Outcome of Scaphoid Excision and Four-Corner Arthrodesis for Advanced Carpal Collapse at a Minimum of Ten Years. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.01.025

[17] Wrist Arthrodesis with Excision of the Proximal Carpal Bones Using the AO/ASIF Wrist Fusion Plate and Local Bone Graft. Journal of Hand Surgery. 2001. DOI: 10.1054/jhsb.2000.0488

[18] Limited Arthrodesis of the Wrist for Treatment of Giant Cell Tumor of the Distal Radius. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.04.026

[19] Wrist arthrodesis as a salvage procedure for failed implant arthroplasty. Journal of Hand Surgery (European Volume). 2010. DOI: 10.1177/1753193410376283

[20] Load_transfer_through_the_radiocarpal_joint_and_the_effects_of_partial_wrist_art_1753193412441761. 1934.

[21] Assessment of Wrist Function After Simulated Total Wrist Arthrodesis. HAND. 2016. DOI: 10.1177/1558944715626930

[22] Total Wrist Arthrodesis: Indications and Clinical Outcomes. Journal of the American Academy of Orthopaedic Surgeons. 2017. DOI: 10.5435/jaaos-d-15-00424

[23] Functional outcomes after salvage procedures for the destroyed wrist: an overview. Journal of Hand Surgery (European Volume). 2019. DOI: 10.1177/1753193419876063

[24] Range of Motion Effects of Distal Pole Scaphoid Excision and Triquetral Excision After Radioscapholunate Fusion: A Cadaver Study. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.02.007

[25] A Cost-Utility Analysis of Nonsurgical Management, Total Wrist Arthroplasty, and Total Wrist Arthrodesis in Rheumatoid Arthritis. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2009.12.013

[26] Surgical management of osteoarthritis of the hand and wrist. Journal of Hand Therapy. 2022. DOI: 10.1016/j.jht.2022.01.001

[27] Early Experience With Locked Intramedullary Wrist Arthrodesis. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2020.11.015

[28] Total wrist arthrodesis in patients with advanced osteoarthritis: current implants and outcomes. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934241295343

[30] Radiolunate and Radioscapholunate Arthrodeses as Treatments for Rheumatoid and Psoriatic Arthritis: Long-Term Follow-Up. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2011.10.012

[31] Ten-Year Minimum Follow-Up of 4-Corner Fusion for SLAC and SNAC Wrist. HAND. 2016. DOI: 10.1177/1558944716681949

[32] Surgical Treatments for Scapholunate Advanced Collapse Wrist: Kinematics and Functional Performance. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.04.035

[33] Reproducibility and Accuracy of a New Method for Measuring the Range of Dart-Throwing Motion. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.01.013

[34] Complications of Limited and Total Wrist Arthrodesis. Hand Clinics. 2010. DOI: 10.1016/j.hcl.2009.11.003

[35] International Federation of Societies for Surgery of the Hand 2013 Committee's Report on Wrist Dart-Throwing Motion. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.02.035

[38] The effect of intercarpal arthrodeses on wrist kinematics during radial and ulnar deviation: a cadaveric study using four-dimensional CT. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231176004

[40] Clinical Outcomes of Arthrodesis and Arthroplasty for the Treatment of Posttraumatic Wrist Arthritis. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2013.02.013

[41] Dynamic In Vivo Evaluation of Radiocarpal Contact After a 4-Corner Arthrodesis. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.11.028

[42] Scaphoid Excision and 4-Bone Arthrodesis Versus Proximal Row Carpectomy: A Comparison of Contact Biomechanics. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2012.05.040

[43] Relative Contributions of the Midcarpal and Radiocarpal Joints to Dart-Thrower’s Motion at the Wrist. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2017.10.017

[44] The Effect of Capitate Position on Coronal Plane Wrist Motion After Simulated 4-Corner Arthrodesis. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2016.07.101

[45] A Retrospective Pilot Study Comparing the Number of Therapy Visits Required to Regain Functional Wrist and Forearm Range of Motion following Volar Plating of a Distal Radius Fracture. Journal of Hand Therapy. 2009. DOI: 10.1016/j.jht.2009.06.003

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[56] Clinical and Imaging Findings of Wrist Tuberculosis: A Study of 47 Patients. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2025.05.015

[57] Efficacy and Safety of Ultrasound-Guided Distal Blocks for Analgesia Without Motor Blockade After Ambulatory Hand Surgery. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.01.011

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