Functional and patient-reported outcome of partial wrist denervation versus the Mannerfelt wrist arthrodesis in the rheumatoid wrist

Philip L Riches, Firas K Elherik, Steffen J Breusch

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: Wrist arthrodesis offers high success rates in patients with rheumatoid arthritis; however, loss of residual mobility may cause unnecessary disability. This makes wrist denervation an appealing alternative. However, there is a distinct lack of patient-reported outcome measure studies comparing these two procedures. The aim of this study was to report any change in function, pain and satisfaction following wrist arthrodesis compared to denervation in a single surgeon series of rheumatoid patients.

PATIENTS AND METHODS: The results of 16 wrist arthrodesis in 15 patients and 14 partial (PIN) wrist denervations in 13 patients were compared with a mean follow-up period of 39 and 22 months, respectively. The primary outcome measures were the same for both groups and included the validated patient-rated wrist evaluation questionnaire and a satisfaction questionnaire.

RESULTS: Wrist arthrodesis significantly improved the mean total pain and functional outcome scores by 54 and 36 %, respectively, at the time of follow-up. Wrist denervation patients also reported significant improvements of 44 and 42 % in total pain and functional outcomes, respectively; 87 % reported being very satisfied with their wrist arthrodesis procedure compared to 78 % in the denervation group. No statistically significant difference in response between the groups was observed in this series of patients.

CONCLUSIONS: Both procedures enjoyed favourable results amongst patients with excellent satisfaction outcomes. PIN denervation is a simple procedure with low complication rates and we therefore consider it a valid alternative to more difficult treatment options, such as partial or total wrist arthrodesis.

Original languageEnglish
Pages (from-to)1037-44
Number of pages8
JournalArchives of Orthopaedic and Trauma Surgery
Issue number7
Publication statusPublished - Jul 2014


  • Aged
  • Arthritis, Rheumatoid
  • Arthrodesis
  • Denervation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Patient Outcome Assessment
  • Patient Satisfaction
  • Prospective Studies
  • Questionnaires
  • Wrist Joint


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