Fusion of selected bones of the carpus, occasionally combined with the radius or metacarpal bases, has been used to treat a wide variety of serious pathologic conditions of the wrist. Indications include severe localized degenerative arthritis and posttraumatic changes secondary to subluxation, dislocation, or residual instability resulting in significant pain. The procedure was performed on 28 wrists in 26 patients. There were three failures to obtain union initially, two of which united after secondary grafting procedures. All patients had less pain and most had functional, though limited, ranges of wrist motion. Limited wrist arthrodesis provides a workable alternative to complete wrist fusion and Silastic wrist arthroplasty for many wrists with localized destruction.