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The purpose of this study was to investigate the medium-term results (mean follow-up, 8 years) of a series of 14 trans-scaphoid dorsal perilunate fracture-dislocations treated operatively at an average of 6 days following injury. Eleven underwent open reduction and internal fixation through a dorsal approach. Combined palmar and dorsal approaches were used in only three cases, for open reduction and internal fixation in two and proximal row carpectomy in one. The Mayo wrist score revealed five excellent, three good, five fair and one poor result. The average score was 79% (range 55-95%). All internally fixed scaphoids healed and no lunate or scaphoid fragment avascular necrosis with collapse was observed. Carpal alignment was satisfactory in most cases. Post-traumatic radiological midcarpal and/or radiocarpal arthritis were almost always observed at follow-up, but this did not correlate with the Mayo wrist score.

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This study reports the current results of an international multicenter study of one last generation total wrist arthroplasty (TWA) ("ReMotion," Small Bone Innovation, Morristown, PA).The two first authors (G.H. and M.B.) built a Web-based prospective database including clinical and radiological preoperative and postoperative reports of "ReMotion" TWA at regular intervals. The cases of 7 centers with more than 15 inclusions were considered for this article.A total of 215 wrists were included. In the rheumatoid arthritis (RA; 129 wrists) and nonrheumatoid arthritis (non-RA; 86 wrists) groups, there were respectively 5 and 6% complications requiring implant revision with a survival rate of 96 and 92%, respectively, at an average follow-up of 4 years. Within the whole series, only one dislocation was observed in one non-RA wrist. A total of 112 wrists (75 rheumatoid and 37 nonrheumatoid) had more than 2 years of follow-up (minimum: 2 years, maximum: 8 years). In rheumatoid and non-RA group, visual analog scale (VAS) pain score improved by 48 and 54 points, respectively, and QuickDASH score improved by 20 and 21 points, respectively, with no statistical differences. Average postoperative arc of wrist flexion-extension was 58 degrees in rheumatoid wrists (loss of 1 degree) compared with 63 degrees in non-RA wrists (loss of 9 degrees) with no statistical differences. Grip strength improved respectively by 40 and 19% in rheumatoid and non-RA groups (p ¼ 0.033). Implant loosening was observed in 4% of the rheumatoid wrists and 3% of the non-RA wrists with no statistical differences.A Web-based TWA international registry was presented. Our results suggest that the use of the "ReMotion" TWA is feasible in the midterm both for rheumatoid and non-RA patients. This is a significant improvement compared with the previous generation TWA.

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