A 51-year-old woman had a progressively painful and stiff right wrist. She had an injury to the wrist many years ago but had not received treatment. The pain and stiffness was interfering with routine daily activities as well as minimally stressful tasks at work.

Examination revealed very limited wrist motion: 10° of flexion, 20° of extension, 10° of ulnar deviation and 5° of radial deviation. Pronation was 90° and supination was 80°. There was crepitance and pain with wrist motion. Mild and tenderness were present.

Preoperative x-rays

PA and lateral views of the wrist show collapse of the scaphoid and surrounding arthritis. Degeneration has developed between capitate head and the lunate. The lunate is fixed in extension and there is general loss of carpal alignment.

Postoperative x-rays for Patient 3

Prosthesis is well aligned. It was implanted without cement. No evidence of complications.

Follow-up

The wrist is performing well without pain. She is using the hand routinely at home and at work. The problems of fatigue, pain and stiffness are gone.

Right wrist examination revealed 35° of flexion, 38° of extension, 15° of ulnar deviation, 8° of radial deviation and near full forearm rotation. Grip strength is 80% of the opposite side.