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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Functional result of wrist arthrodesis in severe injuries of braquial traumatic plexus. Initial experience

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  • presenting/speaker Maria Hortencia Coria Doncel - Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
  • Gustavo Javier Nizzo Miguens - Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
  • Flavio Cesar Ivalde - Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
  • Nicolás José Marazita - Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
  • Nestor Danilo Batalgia - Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina
  • María Victoria Gonzalez - Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1078

doi: 10.3205/19ifssh0375, urn:nbn:de:0183-19ifssh03755

Published: February 6, 2020

© 2020 Coria Doncel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Report the functional result of wrist arthrodesis in 3 patients, treated at our university hospital.

Methods: This is a descriptive, cohort study that reports the result in 3 male patients diagnosed with a complete traumatic right brachial plexus injury. All of them present a postoperative follow-up of 12 months. For the selection of these patients, it was previously confirmed that they presented stability of shoulder and elbow flexion of 110 degrees with adequate function of trapezius, serratus anterior and pectoralis major and minor. The presence of neuropathic pain, the presence of radiographic consolidation of the arthrodesis and functional capacity were evaluated using the modified quick DASH scale befor ande after the surgical intervention and throughout the follow-up. This allowed us to determine concisely the improvement of the overall function of the upper limb.

All our patients were included in the same rehabilitation protocol, carried out by our kinesiologist, always making decisions in conjunction with the surgical team.

Results and Conclusions: The patient achieves work reinsertion, clinically and visually arthrodesis allows him to perform load work (3 kg) achieving good press with arthroded hand, in this way he is partially incorporated into the external environment, improving their living conditions; both professionally and psycho-socially.

We consider that the reconstruction of the function of the member in stages could be a viable option, the wrist arthrodesis would be the last link of this reconstruction, and would represent the clasp of the scapular waist. We believe fundamental the management of these patients by an interdisciplinary team made up of kinesiologists, neurosurgeons and traumatologists for the evaluation of the lost functions to recover. We acknowledge that the sample size is small and that a greater number of cases could grant these conclusions, however we can cautiously say that this would be the first functional recovery report at 12 months after wrist arthrodesis.