A case report of a rheumatoid wrist arthroplasty using a silastic flexible hinge implant with grommet.

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The titanium wrist joint grommet was designed by Alfred B. Swanson, M.D., and is made by Dow Corning Wright. With this grommet the silastic flexible implant can be protected from the bone cut end. The author has experienced a rheumatoid case whose wrist joint was reconstructed by a flexible implant and grommet 27 months prior to this report. The results are as follows: 1. This was no pain in the operated-on wrist joint. 2. The reconstructed joint showed no deformity or swelling, and retained some degree of active motion arc. 3. A progression of bone remodeling was revealed around the implant and grommet on postoperative X-rays. 4. X-rays showed no motion at the grommet-bone interface. Resection interposition arthroplasty using a Swanson implant was an excellent procedure for the rheumatoid wrist joint, even before there was a grommet. As the grommet acts as a protective interface between the wrist joint implant and the bone, we will be able to reconstruct the arthritic joint with greater success.
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