Long-term outcomes of wrist procedures and treatments in adults: A Systematic review of durability, complications, and patient satisfaction
Bibliographic record
Abstract
Introduction Wrist procedures—including prosthetic implantation, internal fixation, and adjunctive therapies—aim to improve function and alleviate pain in adults with arthritis, complex fractures, and degenerative osteoarthritis. Despite advances in implant design and surgical techniques, long-term outcomes remain unpredictable due to complications such as loosening, implant fracture, and fixation failure. Objective We conducted a systematic review to evaluate long-term outcomes of adult wrist procedures and treatments, emphasizing implant durability, complication rates, and patient satisfaction. Methods We searched PubMed, Embase, and Cochrane without language or date restrictions for randomized clinical trials and observational studies that enrolled at least ten adult patients undergoing wrist procedures (including prosthetic arthroplasty, fixation methods, and adjunctive interventions). We extracted data on time to implant or fixation failure, complication incidence, and patient-reported outcomes (DASH and VAS scores). Two independent reviewers screened titles, abstracts, and full texts and assessed risk of bias using RoB 2.0 and the Newcastle–Ottawa Scale. Results Eight studies (1,351 participants) met inclusion criteria. In one prosthesis-focused cohort, the Universal 2 implant demonstrated a 78% survival rate at 10 years but experienced high rates of loosening and implant fracture (52%). Across fixation and surgical trials, functional scores (DASH) improved from a mean of 85 to 52 points (p < 0.05) over 5 years. However, up to one-third of patients required surgical revision due to mechanical failures or complications. Cryotherapy trials reduced in-hospital analgesic use but did not significantly alter long-term pain scores. Discussion Although wrist prostheses and fixation strategies often yield early gains in mobility and pain relief, mechanical complications limit their long-term success. Reported survival and revision rates align with prior literature, underscoring an urgent need for more durable materials, improved fixation techniques, and standardized outcome metrics. Variability in study design and heterogeneous use of PROMs (DASH vs. PRWE) hinder direct comparisons.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.042 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.009 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".