A 67-year-old female has had rheumatoid arthritis for the past 7 years. She is moderately active including light gardening. With the exception of her right wrist, joint swelling and pain is controlled by medications. Pain was nearly constant during routine activities. She asked if there was an option beside wrist fusion as she had tried a wrist brace and found the lack of wrist motion significantly reduced her function.

Range of wrist motion was painful during examination, however she could achieve approximately 35° of extension and 40° of flexion, 5° of radial deviation and 25° of ulnar deviation. Pronation was 70° and supination was 85°. There was mild swelling and some crepitance.

Preoperative x-rays

PA and lateral views of the wrist show diffuse arthritis, but good alignment and satisfactory bone density.

Postoperative x-rays

Good prosthesis alignment is seen. It has been implanted without cement. There is no evidence of loosening.

Follow-up

She reports good relief of pain. She is using the hand and wrist regularly without difficulty. The joint feels normal and strong. The motion is satisfactory for her daily activities. Examination showed 35° of flexion and 35° of extension. Full rotation of the forearm. The prosthesis is stable during motion. There is no evidence of complications.