A complicated course of extensor carpi ulnaris tendon luxation

Schmidt, Ingo; Beylich, Tino

doi:10.15761/tec.1000191

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“…Limited or complete wrist or distal radioulnar joint (DRUJ) motion with or without pain is subsequently followed by impaired power and performance both in elbow and shoulder [16,22,23]. This pattern can be compensated by increased activities of trunk and shoulder muscles (upper trapezius and deltoideus) or using the other unaffected hand or both hands more often but over a not clearly known time [24][25][26].…”

Section: Introductionmentioning

confidence: 99%

Total Wrist Replacement: State of the Art, Challenges and Pitfalls: A Comparative Review

Schmidt¹

2022

Arch Clin Trials

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Background Total wrist replacement (TWR) as motion-preserving procedure continues to be critically discussed in the literature, although the complication rates have been significantly reduced with the current 3rd generation designs compared with older types. Possible reasons for this are often also a lack of knowledge about the currently available evidence, the complication management, and the lack of practical experience by the surgeons. Methods Based on an extended review of literature and own experience, the aim of this article is to give practicable insights for the clinician on: (1) biomechanical fundamentals, (2) differences in design, survivorship and functional outcome between the recent types, (3) possible pitfalls, and (4) failures and salvage options. Results The goal of TWR is that the overall wrist motion is maintained respectively improved despite it works with a locked midcarpal joint. Regarding survivorship and functional outcome the Maestro is (was) being superior over all other types that is (was) based on features in design. There is no scientific evidence as to why the Maestro was withdrawn from the marketplace by the company. For assessment of instability and/or impingement the use of dynamic radiographs is recommended. The problem of TWR is unchanged failure of the carpal components primarily based on mechanical dysbalance, and secondarily followed by metal and/or polyethylene wear, but surgical revision of asyptomatic periprosthetic osteolysis without safe radiagraphic signs of loosening is only required in not more than 20% of cases. For a failed TWR, revision TWR or conversion to total wrist arthrodesis are viable salvage options. Conclusions The knowledge about recent evidence and features in design of the available types, exact assessment of radiographic findings, presence of technical skills by the surgeons, and observance of the patient's expectations are the basic requirements for a successful TWR.

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Section: Introductionmentioning

confidence: 99%

Total Wrist Replacement: State of the Art, Challenges and Pitfalls: A Comparative Review

Schmidt¹

2022

Arch Clin Trials

View full text Add to dashboard Cite

show abstract

A complicated course of extensor carpi ulnaris tendon luxation

Cited by 1 publication

References 0 publications

Total Wrist Replacement: State of the Art, Challenges and Pitfalls: A Comparative Review

Total Wrist Replacement: State of the Art, Challenges and Pitfalls: A Comparative Review

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