Arthrodesis is the process of fusing bones together – usually in the case of a failing joint with chronic instability and pain. It allows bones that make up the joint to grow together, or fuse, into one solid bone.

The procedure is an alternative to complete joint replacement or arthroplasty and is often used in conditions of the wrist. While it is effective in eliminating pain associated with painful degenerative conditions, it limits range of motion.

The goal of arthrodesis is to limit motion by obtaining bony consolidation of worn joint surfaces and eliminate the pain generated when articular surfaces lose their cartilage covering and bone is allowed to rub directly against bone within a joint.

Both total and limited wrist arthrodesis are very important for an array of conditions affecting the wrist joint. Both were initially developed to decrease the pain of wrist joint arthritis and required periods of immobilization, in order to ensure healing and adequate fusion. Eventually internal fixation with plates and screws eliminated the need for external immobilization following arthrodesis.

Today a total wrist arthrodesis utilizes a special compression plate that allows rigid fixation with larger screws proximally and smaller screws distally, in order to reduce the risk of fracturing the metacarpals. Limited intercarpal arthrodeses continue to utilize combinations of Kirschner wires (K-wires), compression bone screws, staples and structural bone grafting.

New specialty plate and screw constructs are being introduced in both limited and total arthrodesis, which today are procedures indicated for trauma, carpal instability, avascular necrosis, tumor damage, septic and rheumatoid arthritis. Arthrodesis may also be used for stabilization of the wrist when combined with tendon transfers, in the correction of deformities, as well as in the salvage of unsuccessful wrist arthroplasty.