Warfare injuries to the wrist. Fusions and motion-preserving procedures.

Abstract

This retrospective study reports the outcome of secondary reconstruction after severe combat-related injuries to the wrist. Fifteen patients with a median age of 36 years were included. Nine patients underwent total wrist arthrodesis and six had a motion-preserving procedure. In patients with wrist injuries involving the distal radius, concomitant bone defects of the ulna, lunate and scaphoid are often present, making wrist motion-preserving surgical procedures challenging. Total wrist arthrodesis required iliac crest bone grafting in all but one case. The final median QuickDASH score for the fusion group was 50, and the final median grip strength was 10 kg. Motion-preserving procedures provided a 50° arc of movement with a final median QuickDASH of 34 and median grip strength of 6 kg. Total wrist joint arthrodesis was the primary salvage solution.Level of evidence: IV.