Arthrodesis of the wrist: past and present.

Arthrodesis of the wrist is a well established procedure that may be performed by a variety of techniques. The position of 10 degrees to 30 degrees of extension and 0 degree to 15 degrees of ulnar deviation is the most commonly accepted position for maximum hand function. Van Gemert has written an extensive monograph reviewing the results after wrist arthrodesis. He concluded that only 42% of 66 patients reviewed met all of the following desired criteria: bony union, subjective improvement of pain, improved power of grip and pinch, no loss of function in adjacent joints, and a good ergonomic score by the system that they used. A review of our cases of wrist arthrodesis shows many of the problems noted by Clendenin and Green. Our review also indicates that patients who make occupational transitions to less hand intensive activities have a better response to the procedure.