Figure 1
For patients with severe wrist conditions, the total wrist joint replacement (TWA) has become an increasingly feasible wrist fusion alternative. However, the long -term effectiveness of TWA, especially the role of lock screws, has always been the theme of continuous debate. The recent case research of Dr. Ingo Schmidt, the practice of the German private environmental practice, was published in the Global Online Magazine of Surgical Magazine. After eight years of follow -up of a patient, a new inspiration was published. The patient accepted the patient. The second TWA type master wrist prosthesis.
Dr. Schmidt introduced a very rare middle -aged woman in detail. The woman was diagnosed with Campanacci II giant cell tumors and the capsule bone with her right wrist. Initially treated with spine and bone transplantation. However, the patient experienced repeated wrist pain, which led to a series of intervention measures, including four -corner fusion and eventually implanted the type of the second master’s wrist prosthesis. The prosthesis is famous for using the use of lock screws, and inserted into the two failed sports saving procedures (Figure 1).
During the eight -year follow -up, the patient showed a complete but asymptomatic blood vessel necrosis of all previously inserted bone transplanting plants around the fixed nail PEG, but there was no obvious part of the wrist loose (Figure 2). However, opposite to these remarkable radiology discovery, the patient reports high satisfaction and excellent functional results, and is only the smallest pain under load conditions (Figure 3). There is no need to revise the implant.
The study emphasizes the key role of lock screws in enhanced TWA’s durability and function. Dr. Schmidt said: “The use of lock screws can significantly improve the life of wrist joint replacement, and fix the external or internal fixation of the large bone defect in the long bone.”
Interestingly, the case study showed that although the patient experienced the performed bone absorption of blood vessel necrosis, this did not convert it to clinical symptoms or reduction. The patient maintains an excellent wrist function and has the scope and grip of equivalent to the influential wrist. This highlights the potential of lock screws, and even if the bone wicker is presented, it can ensure the mechanical stability of the wrist implant.
The discovery of the report on the case emphasizes the importance of choosing the appropriate wrist implant for patients receiving TWA. Dr. Schmid suggested that the two support lock screws at the implant spiral bone interface minimized the unfavorable shear force to prevent loosening. This stability is critical, especially in the case of the replacement of bone shift plants, because non -lock screws may not be able to provide sufficient fixing and fixing.
The master prosthesis is the first wrist implant in the world that allows lock screws to fix the wrist component. However, although the master has an advantage in terms of survival and functional results, not all other third -generation TWA types (or the fourth -generation type of silicon planting into the first type), the implant is in 2018 in 2018 It was removed from the market in the market that was unprepared from the market in the market, indicating that the implant was no longer profitable for the company.
In this case, TWA successfully challenged the long -term successful challenge of the lock screws that previously worried about the durability of wrist implants. This shows that the correct use of lock screws can significantly extend the life of TWA, thereby reducing the demand for revised surgery. However, Dr. Schmida warned that although the current result is hopeful, there is still a long -term loose potential and continuous surveillance is needed.
Dr. Schmid’s research provides valuable insights for the long -term management of TWA, especially the choice of implants and fixed methods. It highlights the considering lock screws in the TWA program to enhance the stability of implant and patient prognosis. With the continuous development of wrist joint replacement, these discoveries will provide information for future surgical practice and implant design to ensure better care for patients with severe wrist conditions.
Journal reference
Ingo. “The key role of lock screws in total wrist replacement: Should we always modify it?” Surgical magazine is online, 2024. Doi: https: //doi.org/10.1016/j.jhsg.2024.01.002
About the author
Dr. Ingo Schmidt Between 1990 and 1999, he graduated from Friedrich-Shiller-UNIVERSITY Hospital (Germany). Trauma, orthopedics, hand and plastic surgeon. In the case of highly intensive joint fractures, Callotaxis and soft tissue chromosomes (PMIDS 8585344_1995 and 33173674_2020) with bone extension (Callotaxis) and Dupuytren disease (PMIDS 85853674_2020), while, Selection of ligaments. After the near -end biceps tendon ruptured, he obtained the MD title in 1994 (PMID 7502385_1995). Then Dr. Schmidt, especially in the field of joint replacement in the entire hand. He is an internationally recognized expert in wrist joint replacement, and has conducted many valuable publications and speeches at Congress and forum, and serves as a reviewer of scientific journals with various highly evaluated scientific journals.
