scholarly journals Resurfacing capitate pyrocarbon implant after proximal row carpectomy: A literature review

2020 ◽  
Author(s):  
Camillo Fulchignoni ◽  
Daniele Caviglia ◽  
Lorenzo Rocchi
Keyword(s):  
Good Alternative ◽  
Review Of The Literature ◽  
Proximal Row Carpectomy ◽  
Wrist Arthrodesis ◽  
Literature Research ◽  
Total Wrist Arthroplasty ◽  
Advanced Stages ◽  
A New Technique ◽  
Pyrocarbon Implant ◽  
Chronic Wrist Pain

Up to a decade ago, to treat patients with chronic wrist pain due to advanced stages of arthritis, surgeons had four main solutions: partial or total wrist arthrodesis, total wrist prosthesis and proximal row carpectomy (PRC). Since 2010, a new technique has been described in literature using the Resurfacing Capitate Pyrocarbon Implant (RCPI), combined to PRC. The aim of this article is to review the literature and determine the indications, outcomes and complications associated with RCPI. An electronic literature research was carried out and pertinent articles were selected. Surgical technique, results and complications described in those articles are presented. From this review of the literature, authors conclude that Resurfacing Capitate Pyrocarbon Implant can be considered as a good alternative to arthrodesis and total wrist arthroplasty, at any ages, when proximal row carpectomy alone would not be indicated.

Prosthetic Replacement of the Scaphoid Proximal Pole: Should It Be the Future?

Hand ◽  
2020 ◽  
pp. 155894472097412
Author(s):  
Matteo Ferrero ◽  
Enrico Carità ◽  
Francesco Giacalone ◽  
Julien Teodori ◽  
Alberto Donadelli ◽  
...  
Keyword(s):  
Avascular Necrosis ◽  
Early Mobilization ◽  
Functional Results ◽  
Good Alternative ◽  
Proximal Row Carpectomy ◽  
Proximal Pole ◽  
Subjective Outcomes ◽  
Clinical Worsening ◽  
Pyrocarbon Implant ◽  
Over Time

Background Scaphoid proximal pole fractures with avascular necrosis represent a complex surgical problem. Many reconstruction techniques are based on osteosynthesis with a vascularized or nonvascularized bone graft. These procedures do not allow early mobilization and therefore sometimes lead to unsatisfying functional results. In some cases, it is possible to perform a scaphoid hemiarthroplasty using a pyrocarbon implant (adaptive proximal scaphoid implant [APSI]) in place of the necrotic proximal pole, allowing an early mobilization and delaying palliative treatments such as 4-corner arthrodesis or proximal row carpectomy. Methods In this study, we reviewed all patients who had undergone a scaphoid hemiarthroplasty using APSI in our institutions from 1999 to 2017; the F.U. was performed through radiographic, clinical, and subjective (Disabilities of the Arm, Shoulder, and Hand) analysis. Results The performances of scaphoid proximal pole implants are encouraging; radiographic, clinical, and subjective outcomes were good, and the functional recovery proved to be fast and reliable over time. Conclusions This study reports our experience in the use of APSI implants, which proved to be a good alternative to traditional techniques for treating avascular necrosis of the proximal pole, still allowing further surgical steps in case of clinical worsening over time (wrist osteoarthritis). These patients are usually young and present high functional demands. Our experience is promising, but we believe that further evaluation over time will be needed.

The use of a pyrocarbon capitate resurfacing implant in chronic wrist disorders

2013 ◽  
Vol 39 (6) ◽  
pp. 611-618 ◽  
Author(s):  
A. Marcuzzi ◽  
H. Ozben ◽  
A. Russomando
Keyword(s):  
Surgical Treatment ◽  
Pain Relief ◽  
Grip Strength ◽  
Surgical Procedure ◽  
Good Alternative ◽  
Proximal Row Carpectomy ◽  
Wrist Arthrodesis ◽  
Wrist Function ◽  
Arthritic Changes ◽  
Indication For Surgical Treatment

The present study describes the technique and results of proximal row carpectomy with resection of the head of the capitate and replacement with a pyrocarbon capitate resurfacing implant. The major indication for surgical treatment was arthritic changes on the head of the capitate. Patients were assessed by range of motion, grip strength, pain and functional scoring, and radiographic studies. In most patients, wrist function was improved and pain relief was obtained. This surgical procedure may represent a good alternative to total and partial wrist arthrodesis.

Technique for Failed Total Wrist Arthroplasty Conversion to a Total Wrist Arthrodesis with Allograft Interposition

2020 ◽  
Author(s):  
Taylor D’Amore ◽  
Asif M. Ilyas
Keyword(s):  
Bone Stock ◽  
Subsequent Increase ◽  
Wrist Arthrodesis ◽  
Interposition Graft ◽  
Total Wrist Arthroplasty ◽  
Cortical Allograft ◽  
Wrist Arthroplasty

AbstractThe frequency of prosthetic total wrist arthroplasty continues to increase. With this increase comes the expected subsequent increase in need for revision or salvage procedures. The technique presented here involves the use of a cortical allograft interposition graft to restore bone stock and length for failed total wrist arthroplasty.

scholarly journals Proximal Row Carpectomy with Total Scapoidectomy vs. Conventional Carpal Resection for ReMotion Total Wrist Arthroplasty

2021 ◽  
Vol 10 (9) ◽  
pp. 1865
Author(s):  
Stefan M. Froschauer ◽  
Matthias Holzbauer ◽  
Dietmar Hager ◽  
Oskar Kwasny ◽  
Dominik Duscher
Keyword(s):  
Grip Strength ◽  
Clinical Assessment ◽  
Complication Rates ◽  
Proximal Row Carpectomy ◽  
Prosthesis Implantation ◽  
Total Wrist Arthroplasty ◽  
Significant Difference ◽  
Flexion Extension ◽  
Wrist Arthroplasty

High complication rates in total wrist arthroplasty (TWA) still lead to controversy in the medical literature, and novel methods for complication reduction are warranted. In the present retrospective cohort study, we compare the outcomes of the proximal row carpectomy (PRC) method including total scaphoidectomy (n = 22) to the manufacturer’s conventional carpal resection (CCR) technique, which retains the distal pole of the scaphoid (n = 25), for ReMotion prosthesis implantation in non-rheumatoid patients. Mean follow-up was 65.8 ± 19.8 and 80.0 ± 28.7 months, respectively. Pre- and postoperative clinical assessment included wrist flexion-extension and radial-ulnar deviation; Disability of Arm, Shoulder, and Hand scores; and pain via visual analogue scale. At final follow-up, grip strength and satisfaction were evaluated. All complications, re-operations, and revision surgeries were noted. Clinical complications were significantly lower in the PRC group (p = 0.010). Radial impaction was detected as the most frequent complication in the CCR group (n = 10), while no PRC patients suffered from this complication (p = 0.0008). Clinical assessment, grip strength measurements, and the log rank test evaluating the re-operation as well as revision function showed no significant difference. All functional parameters significantly improved compared to preoperative values in both cohorts. In conclusion, we strongly recommend PRC for ReMotion prosthesis implantation.

scholarly journals Removal of a Broken Cannulated Intramedullary Nail: Review of the Literature and a Case Report of a New Technique

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Amr A. Abdelgawad ◽  
Enes Kanlic
Keyword(s):  
Case Report ◽  
Intramedullary Nail ◽  
Small Diameter ◽  
New Technique ◽  
Long Bones ◽  
Review Of The Literature ◽  
Tibial Nail ◽  
A New Technique ◽  
Nail Removal ◽  
Real Challenge

Nonunion of long bones fixed with nails may result in implant failure. Removal of a broken intramedullary nail may be a real challenge. Many methods have been described to allow for removal of the broken piece of the nail. In this paper, we are reviewing the different techniques to extract a broken nail, classifying them into different subsets, and describing a new technique that we used to remove a broken tibial nail with narrow canal. Eight different categories of implant removal methods were described, with different methods within each category. This classification is very comprehensive and was never described before. We described a new technique (hook captured in the medulla by flexible nail introduced from the locking hole) which is a valuable technique in cases of nail of a small diameter where other methods cannot be used because of the narrow canal of the nail. Our eight categories for broken nail removal methods simplify the concepts of nail removal and allow the surgeon to better plan for the removal procedure.

scholarly journals Ulna Autograft for Wrist Arthrodesis: A Novel Approach in Failed Wrist Arthoplasty

2017 ◽  
Vol 11 (1) ◽  
pp. 768-776 ◽  
Author(s):  
Nastaran Sargazi ◽  
M. Philpott ◽  
A. Malik ◽  
M. Waseem
Keyword(s):  
Multidisciplinary Approach ◽  
Surgical Intervention ◽  
Salvage Surgery ◽  
Wrist Arthrodesis ◽  
Novel Approach ◽  
Total Wrist Arthroplasty ◽  
Stage Disease ◽  
Wrist Function ◽  
End Stage ◽  
Wrist Arthroplasty

Rheumatoid arthritis is a polyarthropathy affecting approximately 1% of the population worldwide. Wrist involvement is observed around 75% of patients, resulting in substantial disability and morbidity. A multidisciplinary approach to management of such patients is undertaken to prevent disease progression, many go on to develop debilitating disease requiring surgical intervention. Total wrist arthroplasty and arthrodesis are the main options available for those with end-stage disease, with arthroplasty preferred due to its ability to preserve a good degree of wrist function. Where complications occur with total wrist arthroplasty, salvage surgery with arthrodesis can be considered, however this requires satisfactory bone stock to enable stable fusion of the joint following arthroplasty. We report our experience of Ulna strut allografts in wrist arthrodesis in the management of failed total wrist arthroplasty.

scholarly journals Universal 2 total wrist arthroplasty for the salvage of failed Biaxial total wrist arthroplasty

2019 ◽  
Vol 44 (6) ◽  
pp. 614-619 ◽  
Author(s):  
Hero J. A. Zijlker ◽  
Merel J. Berkhout ◽  
Marco J. P. F. Ritt ◽  
Niels van Leeuwen ◽  
Cees B. IJsselstein
Keyword(s):  
Level Of Evidence ◽  
Wrist Arthrodesis ◽  
Evaluation Scores ◽  
Total Wrist Arthroplasty ◽  
Hand Evaluation ◽  
Wrist Arthroplasty

Universal 2 implants may be an alternative to total wrist arthrodesis for the salvage of failed Biaxial total wrist prostheses. We assessed 40 Universal 2 revision implants retrospectively. Fourteen of these wrists were converted to total wrist arthrodeses, and two wrists received a third total wrist arthroplasty after a mean period of 5.5 years. Twenty-four of the Universal 2 implants that remained in situ after a mean follow-up of 9 years (range 4 to 13 years) were re-examined. Sixteen functioned satisfactorily. Patient-Rated Wrist and Hand Evaluation scores and Quick Disabilities of the Arm, Shoulder and Hand scores were 53 and 47, respectively. Twenty-nine patients would choose the Universal 2 again and would also recommend it to other patients. The survival of the revision implants was 60% at a mean follow-up of 9 years. Level of evidence: IV

scholarly journals Functional outcomes after salvage procedures for the destroyed wrist: an overview

2019 ◽  
Vol 45 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Michel E. H. Boeckstyns
Keyword(s):  
Patient Reported Outcomes ◽  
Functional Results ◽  
Well Being ◽  
Salvage Procedure ◽  
Proximal Row Carpectomy ◽  
Wrist Arthrodesis ◽  
Patient Reported ◽  
Surgical Options ◽  
The Common ◽  
Clinical Measurements

The most widely used procedures for salvaging a destroyed wrist are four-corner arthrodesis, radiocarpal arthrodesis, proximal row carpectomy, total wrist arthrodesis, and total wrist replacement or resurfacing. The purpose of this article is to give an overview of the functional results obtained with the various salvage procedures and of the common methods for assessing the surgical outcomes. The outcomes are assessed by clinical measurements and scoring methods, but the actual functional status and well-being of the patients should be presented together with patient-reported outcomes. No salvage procedure can restore entirely full wrist function. Understanding indications, risks, and the outcomes of these procedures would favour a better decision for surgery and help choose the proper treatment from among the surgical options discussed with patients.

Wrist Arthroplasty to Facilitate Communication in the Hearing Impaired

2020 ◽  
Vol 25 (03) ◽  
pp. 384-387
Author(s):  
Brahman Sivakumar ◽  
Joshua Piercey ◽  
David Graham
Keyword(s):  
Rheumatoid Arthritis ◽  
Sign Language ◽  
Gold Standard ◽  
Operative Management ◽  
Hearing Impaired ◽  
Wrist Arthrodesis ◽  
First Case ◽  
Total Wrist Arthroplasty ◽  
Non Operative Management ◽  
Wrist Arthroplasty

Management of wrist arthritis may involve many options, including motion preserving and motion sacrificing procedures. Total wrist arthrodesis is often considered the gold standard for severe wrist arthritis, failing non-operative management. We present the first case to our knowledge of total wrist arthroplasty (TWA) for patient with rheumatoid arthritis who is also deaf, requiring sign language for communication with excellent results.

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