Die radiolunäre Rearthrodese

Abstract

Since 1983, radiolunate arthrodesis has been the gold standard for stabilising the rheumatic wrist. Rearthrodesis of the radiolunate joint has not yet been described. In a prospective study on five radiolunate rearthrodeses with a dorsal mini titanium plate and oblique screw, bone healing was achieved in four. Fatigue fracture of the plate occurred in one case of delayed bone healing. After another rearthrodesis using the same technique, bone healing was achieved. Complete fusion of the wrist can be avoided after failed radiolunate fusion using the described operative technique for rearthrodesis of the radiolunate joint. Preserving some wrist mobility is of high value for these multimorbid patients.

Radiolunate fusion in the rheumatoid wrist via three point fixation with a mini-titanium-T-plate and oblique screw

“…With this construct the lever arm is reduced via the oblique screw. This new procedure, first performed in revisionarthrodesis of a radiolunate non-union [10] offers a high primary stability. Thus the authors elected to use it for primary and secondary radiolunate fusions.…”

“…This prompted the authors to seek a method of stable fixation that adequately neutralized extension, flexion, radial/ulnarabduction, rotation and translation of the lunate on the radius. In 2000, the authors performed their first radiolunate fixation using a new technique for re-arthrodesis post failed staple-fixation [10]. Due to the high primary stability of the osteosynthesis, it was decided to use this novel technique in both primary and secondary radiolunate fusions.…”