Wrist Salvage Procedure Using Second Metacarpal Plate Placement – Total Wrist Fusion Plating System

William Geissler, MD. A 47-year-old patient with a history of multiple surgeries, clinical deformity, and chronic infections subsequent to an open distal radius and ulna fracture injury was treated with the Acumed Total Wrist Fusion Plating System. Patient History: The patient is a 47-year-old male with a history of approximately 20 previous operations at an institution in other state. The patient’s original injury was an open fracture of distal radius and ulna. The patient underwent previous irrigation and debridement as well open reduction and internal fixation. Eventually the plates were removed, as the patient had a continued chronic infection to both the distal radius and ulna. Following several debridements, the patient had remained free of any drainage. One of the patient’s previous surgeries was an attempt at distal radioulnar joint stabilization.The patient presented with severe pain to the distal radius and marked clinical deformity to the wrist. The patient had limited active motion to the wrist as well as limited supination. On physical examination, any range of motion to the wrist was quite painful. The previous incisions were not red hot or warm and there was no active drainage. The patient’s lab work returned with a normal CRP and SED rate. Radiographs show a nonunion of both the distal radius and ulna. The patient had minimal remaining distal radius as well as a complete scapholunate dissociation. In addition, radiographs showed a suture device implanted in an attempt to stabilize the distal radial joint.