The Journal of Bone and Joint Surgery, Vol 69, Issue 7 998-1006, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Total wrist replacement using the modified Volz prosthesis
J Menon
Department of Orthopedic Surgery, Kaiser Permanente Medical Center, Fontana, California 92335.
Eighteen total wrist arthroplasties in sixteen patients were done using the
modified Volz prosthesis. The length of follow-up ranged from twenty-four
to sixty-six months, with a mean of forty months. A 100-point scoring
system was used to evaluate the outcome. Muscle imbalance developed in five
wrists, the carpal component became loose in three wrists, and two
prostheses dislocated. In five patients six arthroplasties (33 per cent)
were considered to have failed because one reoperation or more was required
for loosening of the components in two wrists, dislocation in two wrists,
and muscle imbalance in two wrists. Of the remaining twelve arthroplasties
(eleven patients) eight (45 per cent) had an excellent result; two (11 per
cent), a good; and two (11 per cent), a poor result. The over-all rate of
complications was 44 per cent. Patients who had significant preoperative
deformity did poorly postoperatively. The surgeon should be prepared to
perform other types of arthroplasty or an arthrodesis if the extensor
tendons are structurally inadequate, as this may lead to progressive
flexion deformity postoperatively.
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