Wrist arthrodesis: a combined intramedullary pin and autogenous iliac crest bone graft technique.

Forty-six wrist arthrodeses in 36 patients were reviewed. The technique used provided a reliable fusion method for a variety of wrist disorders. The arthrodeses were performed using an autogenous iliac crest bone graft, with an intramedullary Steinman pin placed within the distal radial and third metacarpal shafts, and an obliquely-placed Kirschner wire across the second metacarpal base into the radius. The distal ulna, instead of the radius, was used in patients with radial agenesis. Three patient populations were identified: group 1, connective tissue wrist disorders; group 2, congenital wrist disorders; and group 3, acquired wrist disorders. A residual flexion, radial deviation deformity was noted with the congenital disorders. All patients had low demand requirements for this fused wrists. The average time of fusion for each group as 14, 15, and 12 weeks, respectively.