The patient came to the clinic 19-February-2012 complaining of inability to use her right upper limb since birth due to traction injury to the right brachial plexus.

On examination, the patient has anesthesia of the entire right forearm and hand with the biceps 4/5,  grip right hand 3/5 extensors right hand 2/5, and 1/5 of the right deltoid and triceps muscle.

The patient was sent for of MRI of the cervical spine with MRMyelography, which confirmed the presence of pseudocele of the right C6-7-8 and D1 roots.

It was discussed with the patient and parents, that the only logical help could be orthrodesis of the right wrist.

Projectional incision over the dorsal side of the wrist. The radial bone and the III MCB and the lunate, capitate and scaphoid were skeletonized and the articular cartilage removed. A bended plate adapted to make the wrist in 10 degrees dorsiflexion with mild ulnar deviation was used to fuse the wrist with three screws tot eh III MC and 3 screws to the radial bone. The bone chips were filled to the articular surfaces to fill the gaps.

Routine closure of the wound. Smooth postoperative recovery.

The patient has old traction injury of the brachial plexus, that the patient cannot use her right upper limb. The aim of surgery is to use her hand in gross activities, such as holding plates or to aid the very weak grip muscles to use the hand in some primitive functions.