Fusion confimed to the radioscaphoid component of the wrist join-it.

Most techniques of fusion of the wrist joint, whether performed through a dorsal approach 1,2,6 or a medial one tend to involve almost the entire wrist complex extending from the distal end of the radius across the carpus. While such diffuse procedures are indicated in the presence of generalized disease of the wrist, the n-iced does arise for a more localized method which conserves part of the joint. It is the purpose of this paper to describe a fusion confined to the radioscaphoid compon-ient of the join-it (Figs. 1 an-id 2). The wrist-joint complex consists of the radiocarpal, mid-carpal, intercarpal, carpometacarpal, an-id intermetacarpal joints. Flexion an-id extension take place at the radiocarpal, mid-carpal, an-id carpometacarpal joints. The total average range of flexion an-id extension is about 140 degrees and of this range about 40 degrees takes place at the mid-carpal and carpomctacarpal joints. In-itercarpal and in-itermctacarpal movement is important in grip. The inferior radio-ulnar join-it is essential for pronation and supination. A localized radioscaphoid fusion, consequently, has the following advantages: ( a) a small but useful residual range of flexion and exten-ison, (b) side to side move-ment, (c) preservation of the grip, and (d) unimpaired movements of pronation and supination. Indications Progressive pain, unrelieved by conservative measures, instability, an-id de-formity of the wrist, associated with impaired hand functioni, were the indications for operation-i