Total modular wrist prosthesis: a new design.

The common modes of failure of total wrist arthroplasty have been fracturing, loosening, pain on pronation and supination, and muscle soft-tissue imbalance. To overcome some of these problems a total modular wrist prosthesis has been designed for use both as a primary prosthesis and for revision surgery. An uncemented and cemented radial component, secure fixation in three metacarpal bones, and an unconstrained and constrained version account for the modularity, including optional treatment of the distal radioulnar joint. We present the design of the prosthesis including the preliminary clinical and radiographic results after a mean follow-up of 20 months in 32 patients of whom four have had earlier implants revised.