Procedure 89 Total Wrist Fusion
See Video 67: Total Wrist Fusion
Indications
Exposures
A dorsal midline incision is used, centered at the radiocarpal joint and extending past the midpoint of the long finger metacarpal and proximally, about 5 cm proximal to the Lister tubercle (Fig. 89-2).
Flaps are elevated, keeping cutaneous nerves in the flaps (Fig. 89-3).
Incise third dorsal compartment and retract the extensor pollicis longus (EPL) tendon (Fig. 89-4).
Raise retinacular flaps, exposing the second to fifth extensor compartments.
A radially based capsular flap is formed by incising the dorsal intercarpal and dorsal radiocarpal ligaments and elevating them off the dorsal triquetrum (Fig. 89-5).
Subperiosteal dissection is used to expose the dorsal radius, the carpus, and the long finger metacarpal (Fig. 89-6).
