Anteromedial Release for Posttraumatic Flexion-pronation Contracture of the Wrist: Surgical Technique

Abstract

Wrist stiffness can be a complication of trauma. A small percentage of patients fail to improve with nonoperative management and require operative intervention to regain range of motion and function. These group of patients can present with a soft tissue flexion-pronation contracture, which is hypothesized to be caused by capsular contraction of the distal radioulna joint, musculotendinous contracture of the flexor carpi ulnaris, contracture of the volar ulnar carpal ligaments and of the pronator quadratus muscle. This complication significantly restricts functional dart-thrower's range of motion and is highly disabling. A surgical option to manage this condition is release of pathologic structures with an anteromedial approach to the wrist. We describe a safe, effective, and reproducible technique to treat these patients.