Comparison of activities of daily living after proximal row carpectomy or wrist four-corner fusion

Abstract

Level III, Therapeutic Study.

Contribution to hand functional assessment based on its kinematics

“…Therefore the core of the thesis is established in the search of contributions to the functional assessment of the hand, focusing on its kinematics. As far as functionality of the hand is concerned, the field of study for this thesis is oriented to assess the ability to perform ADL, to provide a general method suitable for dependency assessment in accordance with many other works (Meiners et al 2002;Foki et al 2016;Brinkhorst et al 2016) and with the widely spread physiotherapists' belief that ADL should be considered in treatments . The state of the art has allowed identifying the lack of agreement in the ADL considered in the different works from literature (Light et al 1999;Light et al 2002), which could be solved using the ICF WHO 2001) as it is the only worldwide recognized reference to assess health aspects.…”

Four-corner arthrodesis of the wrist using Variable Angle Locking Compression Intercarpal Fusion Plate (VA LCP ICF Plate; Synthes ® ): pre- and postoperative radiological analysis and clinical outcome in long-term evaluation

“…However, the biomechanical situation after excision of the proximal carpal row is more dysfunctional due to the creation of incongruent articular surfaces [4], [9]. Furthermore, Brinkhorst et al explored better functional outcomes (according to the Sollerman hand function test) of PCR patients comparing to those with MCA [36]. Additionally, there were specific complications for PCR and MCA mentioned in literature: On the one hand PCR can cause arthrosis in the radiocapitate region (particularly with necessity for denervation procedures), whereas on the other hand MCA may lead to insufficient cartilage removal, persisting pain, lower functional level postoperative, improper realignment of carpal height with nonunion in consequence (particularly with necessity for complete arthrodesis with loss of motion preserving keynote) [2], [4], [5], [9], [10], [11].…”

Functional Outcomes After Salvage Procedures for Wrist Trauma and Arthritis (Four-Corner Fusion, Proximal Row Carpectomy, Total Wrist Arthroplasty, Total Wrist Fusion, Wrist Denervation): A Review of Literature

“…In the literature, no evident data exist regarding patients receiving TWA can load their wrists; Weiss and Akelman [98] advised their eligible patients not to load greater than 10 pounds which contains the implant from a safety perspective. However, there is a trend in literature toward younger patients with good bone stock [67,84,88].…”

“…11 A-B) [118]. Furthermore, the simple and fast denervation of the wrist prior to TWA or TWF in young patients with post-traumatic wrist OA is a suitable and reliable option, does not decrease ROM, has no age limit, preserves grip strength, and still allows other procedures to be performed in the future [67]. Long-term results have been recognized satisfactory pain relief in up to 73% of cases [128 -130], and pain relief was stable over time in 89% of cases at a mean follow-up period of 77 months [131].…”