Results of biaxial total wrist arthroplasty with a modified (long) metacarpal stem.

Abstract

To evaluate the results of Biaxial (DePuy Orthopedics, Inc., Warsaw, IN) total wrist arthroplasty (TWA) with a long metacarpal stem. A retrospective review of the results of 17 long-stem metacarpal components for the Biaxial TWA implanted between 1993 and 1997 is presented. After surgery pain and grip strength improved markedly. Overall motion improved but only radial deviation was significantly better. All of the patients were satisfied. At the most recent follow-up evaluation 4 cases showed evidence of radiographic lucency about the cement mantle, but with no gross loosening or settling. No failures at a greater than 6-year average (4-year minimum) follow-up period have been noted. Two cases of intraoperative third metacarpal fracture and one case of dorsal metacarpal component placement were encountered but did not affect the outcomes. To date the survivorship of the Biaxial TWA with the long stem is favorable compared with previous reports with the standard Biaxial distal component.