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Shortening wrist arthrodesis using a Rush pin in adult spastic wrist: A series of 15 cases.
Hand Surg Rehabil. 2022 02; 41(1):48-53.HS

Abstract

In spastic patients, shortening wrist arthrodesis (SWA) is indicated in cases of severe fixed flexion contracture. At present, the most commonly used technique is dorsal plate osteosynthesis. Ideally, fixation with smaller hardware volume farther from the tendons would limit postoperative tendon irritation and reoperation rates for hardware removal. The objective of our study was to evaluate the efficacy of Rush pin SWA in adults. A retrospective study included all patients with a central neurological impairment, undergoing SWA using a Rush pin inserted through the head of the third metacarpal, and with at least 6 months' follow-up. Attainment of preoperative objectives was evaluated by Global Assessment of Response to Treatment (GART, ranging from -4 to +4) and, for functional objectives, the House score and the Frenchay Arm Test. Consolidation and any degenerative changes in the third metacarpophalangeal joint were assessed on X-ray. Fifteen patients were included, with a mean follow-up of 13 months (range, 6-29). In general, the preoperative objectives were attained: mean GART score was 2.7 (range, 1-4). Functional objectives were attained in 3 of the 11 patients followed up (27%). In all cases, the arthrodesis had healed at a mean 74 days (range, 39-102). Three had hardware removed after consolidation; 1 experienced discomfort at the head of the third metacarpal. Rush pin arthrodesis is an interesting alternative to plate arthrodesis in the management of severe wrist flexion contracture in spastic patients. It gives satisfactory results with regard to preoperative objectives and is not associated with complications. LEVEL OF EVIDENCE: IV, retrospective study without control group.

Authors+Show Affiliations

Orthopedic Surgery Department, University Hospital of Lille, Avenue du Professeur Emile Laine, 59037 Lille Cedex, France. Electronic address: vilestienne@hotmail.com.Orthopedic Surgery Department, University Hospital of Lille, Avenue du Professeur Emile Laine, 59037 Lille Cedex, France.Orthopedic Surgery Department, University Hospital of Lille, Avenue du Professeur Emile Laine, 59037 Lille Cedex, France.Orthopedic Surgery Department, University Hospital of Lille, Avenue du Professeur Emile Laine, 59037 Lille Cedex, France; Department of Anatomy, Henri Warembourg Medical University, Lille University, Place de Verdun, 59040 Lille Cedex, France; University of Lille, 42 Rue Paul Duez, 59000 Lille Cedex, France.University of Lille, 42 Rue Paul Duez, 59000 Lille Cedex, France; Physical Medicine and Rehabilitation Department, Swynghedauw Hospital, University Hospital of Lille, Place de Verdun, 59037 Lille Cedex, France.Orthopedic Surgery Department, University Hospital of Lille, Avenue du Professeur Emile Laine, 59037 Lille Cedex, France; University of Lille, 42 Rue Paul Duez, 59000 Lille Cedex, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34752970

Citation

Lestienne, V, et al. "Shortening Wrist Arthrodesis Using a Rush Pin in Adult Spastic Wrist: a Series of 15 Cases." Hand Surgery & Rehabilitation, vol. 41, no. 1, 2022, pp. 48-53.
Lestienne V, Oca V, Cornu A, et al. Shortening wrist arthrodesis using a Rush pin in adult spastic wrist: A series of 15 cases. Hand Surg Rehabil. 2022;41(1):48-53.
Lestienne, V., Oca, V., Cornu, A., Fontaine, C., Allart, E., & Sturbois-Nachef, N. (2022). Shortening wrist arthrodesis using a Rush pin in adult spastic wrist: A series of 15 cases. Hand Surgery & Rehabilitation, 41(1), 48-53. https://doi.org/10.1016/j.hansur.2021.09.011
Lestienne V, et al. Shortening Wrist Arthrodesis Using a Rush Pin in Adult Spastic Wrist: a Series of 15 Cases. Hand Surg Rehabil. 2022;41(1):48-53. PubMed PMID: 34752970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Shortening wrist arthrodesis using a Rush pin in adult spastic wrist: A series of 15 cases. AU - Lestienne,V, AU - Oca,V, AU - Cornu,A, AU - Fontaine,C, AU - Allart,E, AU - Sturbois-Nachef,N, Y1 - 2021/11/06/ PY - 2021/05/25/received PY - 2021/09/13/revised PY - 2021/09/26/accepted PY - 2021/11/10/pubmed PY - 2022/4/5/medline PY - 2021/11/9/entrez KW - Arthrodesis KW - Arthrodèse KW - Cerebral palsy KW - Clou de Rush KW - Paralysie cérébrale KW - Poignet KW - Poignet spastique KW - Rush pin KW - Spastic wrist KW - Wrist SP - 48 EP - 53 JF - Hand surgery & rehabilitation JO - Hand Surg Rehabil VL - 41 IS - 1 N2 - In spastic patients, shortening wrist arthrodesis (SWA) is indicated in cases of severe fixed flexion contracture. At present, the most commonly used technique is dorsal plate osteosynthesis. Ideally, fixation with smaller hardware volume farther from the tendons would limit postoperative tendon irritation and reoperation rates for hardware removal. The objective of our study was to evaluate the efficacy of Rush pin SWA in adults. A retrospective study included all patients with a central neurological impairment, undergoing SWA using a Rush pin inserted through the head of the third metacarpal, and with at least 6 months' follow-up. Attainment of preoperative objectives was evaluated by Global Assessment of Response to Treatment (GART, ranging from -4 to +4) and, for functional objectives, the House score and the Frenchay Arm Test. Consolidation and any degenerative changes in the third metacarpophalangeal joint were assessed on X-ray. Fifteen patients were included, with a mean follow-up of 13 months (range, 6-29). In general, the preoperative objectives were attained: mean GART score was 2.7 (range, 1-4). Functional objectives were attained in 3 of the 11 patients followed up (27%). In all cases, the arthrodesis had healed at a mean 74 days (range, 39-102). Three had hardware removed after consolidation; 1 experienced discomfort at the head of the third metacarpal. Rush pin arthrodesis is an interesting alternative to plate arthrodesis in the management of severe wrist flexion contracture in spastic patients. It gives satisfactory results with regard to preoperative objectives and is not associated with complications. LEVEL OF EVIDENCE: IV, retrospective study without control group. SN - 2468-1210 UR - https://www.unboundmedicine.com/medline/citation/34752970/Shortening_wrist_arthrodesis_using_a_Rush_pin_in_adult_spastic_wrist:_A_series_of_15_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2468-1229(21)00622-8 DB - PRIME DP - Unbound Medicine ER -