case_images: PMC4342074_01
case_images: Preoperative appearance of wrist showing radiocarpal osteoarthritis.
case_images: CRIOR2015-812807.001.jpg
case_images: PMC4342074_01_CRIOR2015-812807.001.jpg
case_images: fig1
case_images: A 58-year-old paramedic presented with a stiff painful wrist following limited wrist fusion (LWF) with scaphoid retention (scaphocapitolunate fusion) and styloidectomy for a neglected scapholunate disassociation with stage 3 scapholunate advanced collapse (SLAC) and subsequent removal of hardware and open capsular release with significant radiocarpal osteoarthritis (Figure 1).
case_images: Ilizarov wrist distraction fixator assembly.
case_images: CRIOR2015-812807.002.jpg
case_images: PMC4342074_01_CRIOR2015-812807.002.jpg
case_images: fig2
case_images: A 2 mm distraction was immediately applied across the radiocarpal joint (Figure 2).
case_images: Maximal wrist distraction in frame.
case_images: CRIOR2015-812807.003.jpg
case_images: PMC4342074_01_CRIOR2015-812807.003.jpg
case_images: fig3
case_images: A further 5 mm distraction was applied over 12 days paying careful attention to neurological function (Figure 3).
case_images: Postdistraction radiograph showing improved radiocarpal appearance.
case_images: CRIOR2015-812807.004.jpg
case_images: PMC4342074_01_CRIOR2015-812807.004.jpg
case_images: fig4
case_images: At 20 weeks following frame removal final clinical range of motion was from 30-degree dorsiflexion to 70-degree palmar flexion with a 30-degree arc range of motion in radioulnar deviation and pain was significantly improved (Figures 4, 5, 6, and 7).
case_images: Postdistraction radiograph showing improved radiocarpal joint line.
case_images: CRIOR2015-812807.005.jpg
case_images: PMC4342074_01_CRIOR2015-812807.005.jpg
case_images: fig5
case_images: At 20 weeks following frame removal final clinical range of motion was from 30-degree dorsiflexion to 70-degree palmar flexion with a 30-degree arc range of motion in radioulnar deviation and pain was significantly improved (Figures 4, 5, 6, and 7).
case_images: Postdistraction wrist flexion.
case_images: CRIOR2015-812807.006.jpg
case_images: PMC4342074_01_CRIOR2015-812807.006.jpg
case_images: fig6
case_images: At 20 weeks following frame removal final clinical range of motion was from 30-degree dorsiflexion to 70-degree palmar flexion with a 30-degree arc range of motion in radioulnar deviation and pain was significantly improved (Figures 4, 5, 6, and 7).
case_images: Postdistraction wrist extension.
case_images: CRIOR2015-812807.007.jpg
case_images: PMC4342074_01_CRIOR2015-812807.007.jpg
case_images: fig7
case_images: At 20 weeks following frame removal final clinical range of motion was from 30-degree dorsiflexion to 70-degree palmar flexion with a 30-degree arc range of motion in radioulnar deviation and pain was significantly improved (Figures 4, 5, 6, and 7).
case_images: Wrist radiographs showing maintained joint space at 2 years.
case_images: CRIOR2015-812807.008.jpg
case_images: PMC4342074_01_CRIOR2015-812807.008.jpg
case_images: fig8
case_images: This was maintained at 12- and 24-month review without recurrence of symptoms or significant sclerosis (Figure 8).