Wrist Arthrodesis Using the Medartis Carpometacarpal Joint Sparing Plate

• Published in: Hand (New York, N.Y.) Vol. 19; no. 4; pp. 607 - 613
• Main Authors: Briotti, Joshua, Wilson, Stuart, Goh, Geraldine, Lawson-Smith, Matthew
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.06.2024
• Subjects: Adult; Aged; Aged, 80 and over; Arthrodesis - instrumentation; Arthrodesis - methods; Bone Plates; Carpometacarpal Joints - surgery; Disability Evaluation; Female; Follow-Up Studies; Hand Strength; Humans; Male; Middle Aged; Patient Satisfaction; Range of Motion, Articular; Retrospective Studies; Treatment Outcome; Wrist Joint - physiopathology; Wrist Joint - surgery; total wrist arthrodesis; arthrodesis; complications; CMC sparing
• DOI: 10.1177/15589447221141474
• ISSN: 1558-9447; 1558-9455

Background: Total wrist arthrodesis is a well-established surgical technique that provides reliable pain relief in patients with advanced wrist disease. Key limitations of existing plating systems include hardware pull-out, hardware failure, and nonunion. There is limited literature on the newer style carpometacarpal joint (CMCJ) sparing plating system, produced by Medartis. The objective of this study was to determine the long-term clinical and radiological outcomes of wrist arthrodesis with a CMCJ sparing wrist plate. Methods: This study retrospectively identified 23 wrist arthrodeses using the Medartis CMCJ sparing plate for review. This study assessed the outcomes of 18 unilateral wrist fusions and 1 bilateral wrist fusion. The study group consisted of 12 men and 5 women with an average age of 56 years (range: 29-82 years) with a mean follow-up period of 17 months. Results: At the time of follow-up, all patients’ wrists had fused without postsurgical complication. The final grip strength in the operative hand was 28.2 kg/cm2, which was 87% of the contralateral side. The mean Quick Disabilities of the Arm, Shoulder, and Hand score at follow-up was 23.9, with all patients returning to daily living activities and work. Patients reported minimal pain (1.3/10), with almost all (17/18) satisfied with the outcome of the surgery and describing that they would recommend this procedure. Conclusion: Our case series highlights that the Medartis wrist arthrodesis plate is a newer design that is a well-tolerated option for wrist arthrodesis based on clinical assessment, functional hand assessment, and patient satisfaction, when compared with the existing literature on traditional plating systems.