Wedge Arthrodesis of the Wrist

The method of arthrodesis of the wrist here described was originally evolved by Mr E. P. Brockman in a case of severe flexion deformity of the wrist due to a long-standing Volkmann’s ischaemic contracture. Subsequently the method was extended in its application to other cases of flexion deformity of the wrist and later was also used for arthrodesis of the wrist in cases without deformity. Spike arthrodesis, devised and described by Higgs (1931), has now long been used in the operative treatment of hammer toe deformity. The spike of the proximal phalanx well inserted into the socket of the distal phalanx provides relatively large cancellous bone areas in intimate contact and good internal fixation. It is thus comparable to an impacted fracture and sound early union results. The arthrodesed toe is also shortened. In the arthrodesis of the wrist to be described, the lower end of the radius is shaped into a wedge and is then inserted into the carpus which has been split open like an oyster (Figs. 1 and 2). This arthrodesis is thus an extension of the spike arthrodesis adapted and modified to deal with a more complex joint. In addition to providing the pre-requisites for sound bony union, this