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Dorsal Carpal Wedge Osteotomy in the Arthrogrypotic Wrist.
MedLine Citation:
PMID:  23267756     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To assess the outcome of patients who underwent dorsal carpal wedge osteotomy (DCWO) for the treatment of wrist flexion deformities causing functional limitations resulting from arthrogryposis. METHODS: We performed a retrospective chart review of consecutive patients treated with DCWO between 1996 and 2009 by a single surgeon. Follow-up of greater than 1 year (mean, 45 mo; range, 12-108 mo) was available in 12 patients (20 wrists). RESULTS: All 12 patients' parents reported subjective improvement in position and appearance, and in performing activities of daily living. Wrist extension was significantly increased (mean, 43°), wrist flexion was significantly decreased (mean, 34° from neutral), and there was no significant change in wrist motion arc. We saw significantly greater improvement in wrist extension in children operated on at 7 years of age or greater and in patients treated concomitantly with an extensor carpi ulnaris tendon transfer. Complications included 1 infection. CONCLUSIONS: The excessively flexed wrist in children with arthrogryposis can safely and effectively be improved with DCWO, which in turn facilitates independence in activities of daily living and school-related tasks as reported by parents. For patients older than 7 years of age at the time of surgery, and for patients treated with concomitant extensor carpi ulnaris transfer at the time of DCWO, found greater recovery of wrist extension. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Authors:
Ann E Van Heest; Rudy Rodriguez
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-22
Journal Detail:
Title:  The Journal of hand surgery     Volume:  -     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis; and Shriner's Hospital-Twin Cities; Gillette Children's Specialty Healthcare, St. Paul, MN. Electronic address: vanhe003@umn.edu.
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