Motion-preserving wrist reconstruction using a microsurgical medial femur condylus bone graft and radio-scapho-lunate (RSL) limited fusion after osteomyelitis following open distal radius fracture

Abstract

This case presents the microsurgical management in the rare situation after sequestering osteomyelitis of the distal radius to achieve both bony stability and partially preserved wrist motion. A 38-year-old patient underwent after sequestrectomy microsurgical reconstruction using a medial femoral condyle as a prerequisite for simultaneous motion-preserving radio-scapho-lunate (RSL) fusion. As a result, 11 months postoperatively, a good functional result was achieved with range of motion of 60° in extension/flexion and 40° in ulnar/radial deviation and grip strength of 12 kg correspondeding to 33% of the dominant contralateral side. Upper extremity usability as measured by Disability of Arm Shoulder and Hand (DASH) questionnaire improved from preoperative 24 to after the reconstruction and enabled the patient to resume his work without pain.

Keywords

• upper extremety
• osteoarthritis
• reconstructive surgical procedures
• microsurgery
• arthrodesis