American Association for Hand Surgery

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Total wrist type „Remotion - SBI“ in orthopedic trauma-patients. Follow-up of 14 years in 67 cases with a less invasive approach
Dietmar Hager, MD, Common Hospital, Linz, Austria and Stefan M Froschauer, MD, Kepler University Clinic, Linz, Austria

Total wrist type „Remotion - SBI“ in orthopedic trauma-patients. Follow-up of 14 years in 67 cases with a less invasive approach.

Posttraumatic wrist-arthrosis frequently causes significant loss of range of motion accompanied by severe pain resulting in a major decrease of occupational capability. Multiple studies of total wrist fusion, show unsatisfied patients.The wish for preservation of motion is understandable and by means of a total wrist implant it is feasible. Implantation with a less invasive approach yields great benefits.

Full ROM was obtained [average S 45/0/40] within 6 weeks. Painrelease from pre-op average 7-8/10 (VAS) to 1-2/10. 57 patients were totally free of pain. Longterm follow-up is 14 years; short-term follow-up is 2 years. 2 carpale elements have gotten loose, needing re-op. In 5 cases radiological fill around the radial component. No dislocations or instability has been observed. 2 patients had functional loss of extensor tendonds (1 digitiv minimi, 1 ext. dig. 4). All patients confirmed that they would have the procedure done again. 7 Patients have total wrist-implants on both sides. 5 patients were converted from total wrist arthrodesis into remtion implant. Qick DASH scores will be displayed in the presentation. Total wrist-implant „Remotion“ is a highly sophisticated implant, capable of meeting the expectations of both the physician, in terms of criterion for reliability, stability and effective pain relief, as well as meeting the needs of the patients for functional restoration.

As a consequence we regard the total wrist-implant as a”first choice procedure“ in severe cases of arthrosis.

Less invasive approach looks very promising, as complete release of the retinaculum and large skin-incisions are no longer necessary. In comparison the procedure can be done much faster. More importantly patients seem to take great benefit from this technique. Postoperative swelling is significantly lower. Handtherapy can be started much sooner, yielding earlier ROM; consuming less time. However, at present, we believe that the “Remotion“ is the only implant qualifying for this less invasive approach.

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