Functionally optimal wrist alignment in total wrist arthrodesis

In total wrist arthrodesis (TWA), the third metacarpal is typically fixed to the radius with a slight dorsal flexion and ulnar deviation; however, which alignment yields the optimal functional outcome remains uncertain. This study involved healthy subjects whose wrist movements were recorded during the performance of Activities of Daily Living (ADL). Optimal wrist alignment was then found as the average wrist orientation during the ADL. The results indicate that approximately 7 deg of dorsal flexion and 5 deg of ulnar deviation is functionally optimal in TWA during the ADL involved. This study originally focused on transradial prostheses, but the results are potentially relevant for TWA in patients with a healthy contralateral limb.