Children with arthrogryposis show improved long-term outcomes after carpal wedge osteotomy

Pediatric patients who underwent carpal wedge osteotomy for amyoplasia congenita had sustained improvement at 5.7-year follow-up, according to researchers of this study.

“In conclusion, dorsal carpal wedge osteotomy is an effective method for treating flexion contracture of the wrist in patients with arthrogryposis. Correction of the flexion posture of the wrist was improved, and this improvement was sustained over time,” Christian A. Foy, MD, and colleagues wrote in the study. “This operation shifted the arc of wrist motion to a more useful position and did not reduce range of motion to enhance functional independence and improve quality of life.”

Foy and colleagues evaluated the results of 46 patients (75 wrists) with arthrogryposis who were an average of 4.3 years old at the time of surgery. The patients underwent surgery to correct wrist flexion posture, which measured an average 55° of flexion when at rest preoperatively. Parents or guardians completed questionnaires after the surgery regarding patient satisfaction, task completion, surgical outcome and function, according to the abstract.

The average postoperative resting position of the wrist was 11° of flexion. The preoperative arc of motion did not significantly differ from the position postoperatively, at 32° and 22°, respectively. Foy and colleagues noted the motion arc location was “significantly improved to a more functional position.” Average wrist flexion significantly changes from 69° preoperatively to 33° postoperatively and average active wrist extension significantly changed from –37° preoperatively to –11° postoperatively, according to the abstract.

Disclosure: The authors have no relevant financial disclosures.