Vascularized fibular graft after excision of XXXX of the distal radius: wrist arthroplasty versus partial wrist arthrodesis.

@entity1 @entity2967 @entity2968
Several reconstructive procedures have been described for the complete defect of the distal radius that is created after a wide excision of @entity2968 , including hemiarthroplasty using the vascularized fibular head and partial wrist arthrodesis between a vascularized fibula and the scapholunate portion of the proximal carpal row. The objectives of this study are to compare clinical and radiographic results between the partial wrist arthrodesis and the wrist arthroplasty, and to discuss which procedure is superior. Four @entity1 with @entity2967 involving the distal end of the radius were treated with en bloc resection and reconstruction with a free vascularized fibular graft. The wrists in two @entity1 were reconstructed with an articular fibular head graft and the remaining two @entity1 underwent partial wrist arthrodesis using a fibular shaft transfer. There was radiographic evidence of bone union at the host-graft junctions in all cases. In the newly reconstructed wrist joint, there was palmar subluxation of the carpal bones and degenerative changes in both @entity1 . Local recurrence was seen in one @entity1 . According to the functional results described by Enneking et al., the mean functional score was 67 percent. The functional scores including wrist/forearm range of motion in the cases with partial wrist arthrodesis were superior to those with wrist arthroplasty. A partial wrist arthrodesis using a vascularized fibular shaft graft appears a more useful and reliable procedure for reconstruction of the wrist after excision of the @entity2967 of the distal end of the radius than a wrist arthroplasty using the vascularized fibular head, although our study includes only a small number of @entity1 .
