Indications Wrist denervation is indicated in patients with chronic pain but preserved motion after exhausting nonoperative treatments. Patients are candidates for denervation if they have pain from primary degenerative or inflammatory arthritis, osteonecrosis (Kienböck or Preiser disease), or traumatic conditions,…
Indications Total wrist fusion is indicated in patients with pain or instability after failure of nonoperative management and motion-preserving procedures. Wrist fusion is preferred when multiple joints (i.e., the radiocarpal and midcarpal joints) are involved. If disease is isolated to…
Indications Total wrist arthroplasty (TWA) is indicated in low-demand patients with severe wrist pain who require some motion. Potential candidates include patients with osteoarthritis (OA), posttraumatic arthritis, and sometimes rheumatoid arthritis (RA). Although new implant designs show promise, TWA is…
Indications Matched hemiresection ulnar arthroplasty is indicated in patients with distal radioulnar joint (DRUJ) pain from posttraumatic arthritis, osteoarthritis (OA), or inflammatory arthritis with an intact triangular fibrocartilaginous complex (TFCC). The premise of hemiresection arthroplasty is that the DRUJ articulation…
Indications The Sauvé-Kapandji procedure consists of fusion of the distal radioulnar joint (DRUJ) and resection of a short segment of ulna proximal to the joint to preserve forearm motion. It eliminates the painful articulation between the ulna and sigmoid notch…
Indications The goal of surgical treatment of distal radioulnar joint (DRUJ) arthritis is to eliminate the articulation between the distal ulna and the sigmoid notch. Options include distal ulna resection (Darrach procedure) or hemi-resection (Bowers procedure; see Chapter 51 ),…
Indications Carpometacarpal (CMC) joint arthroplasty with trapeziectomy with or without ligament reconstruction provides predictable pain relief for most patients. Revision CMC arthroplasty is indicated in patients with persistent or recurrent basilar thumb pain or instability who are at least 1…
Indications Carpometacarpal (CMC) arthritis is one of the most common conditions treated by hand surgeons. Surgery is indicated in patients who continue to have severe pain or thumb dysfunction despite nonoperative management. Patients with Eaton stage III or IV trapeziometacarpal…
Indications Anterior oblique ligament reconstruction (Littler procedure) is indicated in patients with Eaton-Littler stage I or early stage II trapeziometacarpal (TM) disease with painful instability or diminished thumb function who have failed nonoperative management ( Table 46.1 ). TABLE 46.1…
Indications Initial management options for thumb basilar joint arthritis include activity modification, nonsteroidal antiinflammatory drugs (NSAIDs), splinting, therapy, and corticosteroid injections. Surgery is indicated in patients who continue to have severe pain or poor function despite nonoperative management. The Eaton-Littler…