Results of Mannerfelt wrist arthrodesis for rheumatoid arthritis in relation to the position of the fused wrist |
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Authors: | Martin Lautenbach Michael Millrose Inga Langner Andreas Eisenschenk |
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Institution: | .Department of Upper Extremity, Hand and Microsurgery, Immanuel Hospital, Königstrasse 63, 14109 Berlin, Germany ;.Center for Hand and Functional Microsurgery, University Medicine Greifswald, Sauerbruchstraße, 17475 Greifswald, Germany ;.Department of Hand, Replantation and Microsurgery, Unfallkrankenhaus Berlin, Warener Str. 7, 12683 Berlin, Germany |
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Abstract: | Purpose The wrist is involved early in rheumatoid arthritis and is often severely affected. A stable wrist is crucial to good hand function, which often necessitates a fusion. One of the most commonly used techniques in rheumatoid patients is the Mannerfelt arthrodesis. In this retrospective study the outcome and the patient’s subjective satisfaction are presented and compared to other techniques. Also the influence of the position of the wrist following a fusion procedure is analysed. Methods Thirty-four wrists were retrospectively analysed using radiological measurements, functional scores such as the Disabilities of the Arm, Shoulder and Hand (DASH) and a pain assessment. The objective function of the hand with the fused wrist was assessed. Results In 92.6 % of wrists the patients rated their satisfaction as good or excellent. The mean DASH score post-operatively was 63.3. Of the wrists, 17 were fixed in a median flexed position of 13° and 17 wrists in a median extended position of 8°. There was no statistically significant correlation between the position of the wrist and the satisfaction or objective function. The rate of fusion was 94.1 %. Conclusions The Mannerfelt arthrodesis achieves good results and provides a high rate of satisfaction and pain relief in our study. It has major advantages compared to other wrist fusion techniques in the rheumatoid patient. We could not show clear statistical evidence for better results in either a flexed or an extended position, but the ratings of the patients indicated better subjective results with a slightly extended position of the arthrodesis. |
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Keywords: | Mannerfelt arthrodesis Osteoarthritis Rheumatoid arthritis Wrist arthrodesis |
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