BSSH Autumn abstracts

Abstract

Aims: 1) To evaluate the incidence of non-union, malunion, broken implants, peri-prosthetic fracture, loosening and implant removal. 2) To evaluate improvement in wrist position, hygiene and patient satisfaction. Methods: This is a retrospective review of our patients who underwent wrist fusion for spasticupper limbs secondary to cerebral palsy or stroke. The implant used was a variable angle locking distal radius plate with standard dorsal approach to wrist and carpometacarpal (CMC) joints were not bridged. Proximal row carpectomy (PRC) was performed in all cases and extensor pollicis (EPL) tendon was left subcutaneous. Patients were followed up for assessing complication rates, bony union and overall satisfaction. Visual analogue scale (VAS) was used to assess patient-reported outcomes. Results: Eight wrist arthrodesis were performed over a period of two years in seven patients. Mean age of patients was 26 years and mean follow up is 10 months. Indications for surgery were wrist position producing difficulties. Mean pre-operative wrist flexion, satisfaction scores across most domains on visual analogue scale showed significant improvement. All wrists demonstrated bony union. No implants had to be removed. There were no complaints of implant prominence, implant or tendon irritation, metacarpal prominence or increased extension. No report of implant loosening or periprosthetic fractures. Conclusions: Implant and surgical technique appear to be safe with a low complication rate. Implant can be considered superior to available standard fusion plates on account of profile and size. Commercial implants should be made available in better designs keeping the above factors in mind especially in view of demonstrable benefits in small size limbs. Base of thumb osteoarthritis (BTOA) in the interface – an analysis of management and service structure