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1 Table 1 Outcomes of Selected Studies of Total Wrist Arthrodesis Study Mannerfelt and Malmsten1 Millender and Nalebuff2 Clendenin and Green3 No. of Techniques Wrist s 43 Rush pin, staples 70 18 Steinmann pin, staples or Kirschner wire Bone graft, Millender/Nalebuf f technique Plate (57 wrists), other (33 wrists) Plate 22 Plate Barbier et al7 18 Mannerfelt Carlson and Simmons8 12 Intramedullary Christodoulo u et al9 Clayton10 22 Intramedullary 12 Steinmann pin De Smet and Truyen11 36 Screws, graft (24 wrists); plate (12 wrists) 31 Hastings et al4 Addosooki et al5 Adey et al6 90 Indicationsa Patient Satisfaction Outcome Scoresb Rheumatoid arthritis NR NR Rheumatoid arthritis NR NR Rheumatoid arthritis, other Posttraumati c arthritis Brachial plexus palsy Posttraumati c arthritis NR NR NR NR NR Rheumatoid arthritis Failed total wrist arthroplasty Rheumatoid arthritis Rheumatoid arthritis Mixed 100% satisfied DASH score 43.2 Grip strength 79% DASH score 25 (range, 4– 43) Medical Outcomes Study 36Item Short Form score 39 (range, 29–55) Grip strength 100% NR 68% very satisfied/satisfie d 100% good/excellent 95% completely satisfied 83% satisfied NR NR Grip strength 63% DASH score 44 (22) NR 2 Elherik et al12 15 Mannerfelt Rheumatoid arthritis 93.7% very pleased El-Kazzi et al13 29 External fixation Field et al14 20 Plate Posttraumati NR c arthritis (12 wrists), rheumatoid arthritis (5 wrists), other (12 wrists) Posttraumati NR c arthritis Fontaine et al15 6 Rheumatoid arthritis 5 excellent 1 good Green and Henderson16 110 Bilateral intercalated iliac crest bone graft, Rush pins Plate Posttraumati c arthritis, other NR Houshian and Schrøder17 42 Plate Howard et al18 17 Screws (8 wrists), plate (9 wrists) Posttraumati 90% completely c arthritis satisfied (29 wrists), rheumatoid arthritis (3 wrists), other (10 wrists) Rheumatoid NR arthritis Kluge et al19 104 ClaytonMannerfelt Rheumatoid arthritis 93% excellent/good VAS score 2.5 (range, 0– 8) PRWE scores 45.5 (1–53) for function, 14.2 (range, 0–34) for pain Grip strength 75% DASH score 33 VAS score 2.4 Grip strength 74% VAS score 1.6 (0.2) VAS score 0 Grip strength 98% (dominant), 53% (nondominant ) NR VAS score 1.1 (on 5– point scale) VAS score 0.9 3 Kobus and Turner20 87 Millender/Nalebuf Rheumatoid f technique arthritis 95% satisfied Lautenbach et al21 34 Mannerfelt technique Rheumatoid arthritis 92.6% good/excellent Lee and Carroll22 46 Intramedullary NR Masada et al23 Murphy et al24 18 Intramedullary 24 Variable Rheumatoid arthritis (25 wrists), other (21 wrists) Rheumatoid arthritis Rheumatoid arthritis Nydick et al25,c 15 Maestro total wrist system (Biomet, Warsaw, IN), fusion plate Posttraumati c arthritis Pech et al26 29 L-plate NR Rauhaniemi et al27 115 40% very satisfied VAS score 1.3 (range, 1– 4) Rayan and Young28 Rehak et al29 11 Mannerfelt technique (113 wrists), staples (2 wrists) Plate Rheumatoid arthritis Rheumatoid arthritis Cerebral palsy Rheumatoid arthritis 88% completely satisfied 100% NR Riches et al30 16 Rheumatoid arthritis 88% very pleased 12% fairly pleased PRWE scores 44.6 (19.8) for function, 14.1 (11.4) for pain 57 Intramedullary (25 wrists), plate (32 wrists) Mannerfelt technique Grip strength 57 mm Hg (range, 16– 100 mm Hg) Grip strength 21 kPa (range, 0–46 kPa) DASH score 63.3 (25.3) VAS score 1.9 (range, 0– 9) VAS score 1.1 (on 4– point scale) NR NR 92% very satisfied/satisfie d 60% very/somewhat satisfied NR Grip strength 70% DASH score 29 VAS score 2 Total PRWE score 73 NR NR 4 Rizzo et al31 21 Steinmann pins (9 wrists), Steinmann pins /staples (1 wrist), plates (8 wrists), staples (2 wrists), external fixation (1 wrist) Sauerbier et al32 60 Plate Solem et al33 42 Mannerfelt technique, plate Rheumatoid NR arthritis (34 wrists), other (8 wrists) Toma et al34 42 Rheumatoid arthritis Van Heest and Strothman35 Wagner et al36 41 Mannerfelt technique (19 wrists), plate (23 wrists) Plate 26 Rheumatoid arthritis (15 wrists), juvenile rheumatoid arthritis (1 wrists, psoriatic arthritis (1 wrist) after total wrist arthroplasty Posttraumati c arthritis (45 wrists), other (15 wrists) 82% satisfied/very satisfied DASH score 33 VAS score 2.6 NR Grip strength 50% DASH score 51.4 VAS score 1.65 Grip strength 19 kg (range, 6–47 kg) DASH score 38 (range, 2– 75) VAS score 1.3 NR 98% excellent/good Cerebral palsy 89% satisfied/highly satisfied Plate (12 wrists), Rheumatoid 92% staples and arthritis (20 satisfied/very Kirschner wires (9 wrists), other satisfied wrists), Steinmann (6 wrists) pins (5 wrists) VAS score 1.8 Grip strength 10.9 (2) DASH score 21 (7) Total PRWE score 29 (9) DASH = Disabilities of the Arm, Shoulder, and Hand, NR = not reported, PRWE = PatientRated Wrist Evaluation, VAS = visual analog scale a Other indications included osteoarthritis, Kienböck disease, and psoriatic arthritis. b All outcome scores are given as mean (standard deviation) except as noted. 5 c Study compared total wrist arthrodesis and total wrist arthroplasty. Only the total wrist arthrodesis patients are included.