Wrist Hemiarthroplasty for Complex Intraarticular Distal Radius Fracture in a Patient with Manifest Osteoporosis

Abstract

Distal radius fracture (DRF) is one of the most common fractures of the elderly. The higher the degree of joint surface destruction, and the more adverse factors are involved, the more challenging proper treatment becomes. In this regard, osteoporosis as underlying systemic disease, chondropathy or degeneration of adjacent wrist bones as well as incompliance significantly impair the success of the chosen primary therapy. Wrist hemiarthroplasty has already been reported as primary or secondary procedure for DRFs. In this case report, we present a patient with a severely comminuted DRF including posttraumatic degeneration of the lunate as well as manifest osteoporosis. Wrist hemiarthroplasty using the ReMotion radius component in combination with proximal row carpectomy was performed as secondary surgery. This procedure proved to be a viable treatment option in terms of achieving low pain levels, high range of motion values and stable osteointegration over a course of 6.5 follow-up years.

Wrist Hemiarthroplasty of Irreparable Distal Radius Fracture under Wide-Awake Local Anesthetic and No Tourniquet

“…J-L Roux [ 1 ] suggested treating certain very complex acute fractures by utilizing a wrist hemiarthroplasty, as in complex fractures of the superior and distal humerus in elderly patients. Recent studies of hemiarthroplasty for elderly complex wrist fractures have resulted in good clinical and radiological outcomes, as well as high satisfaction rates [ 2 , 3 , 4 ] and long-term results [ 5 ]. According to Herzberg et al [ 4 ], the indications are still limited as there is no uniform definition of an irreparable fracture but it could be an association of fracture characteristics, such as complex, displaced, distal, and cartilage-involved, with circumferential comminution after CT-scan examination.…”