Everything You Should Know About Orthopedic Wrist Surgery

The wrist consists of eight small bones which connect with two long forearm bones that are called ulna and radius. Your wrist has an important role in the overall functionality of the hand, which is why it is susceptible to damage. Treating these problems promptly can improve the mobility of the hand and functionality of the wrist as well as to decrease the severity of the pain on experiences. Surgical procedure is one of many treatments that doctor may suggest. This article aims to provide useful info about wrist surgery.

Causes of pain in the wrist

Wrist pain isn’t uncommon mostly because repetitive motion that is characteristic for your wrists can cause damage, thus inducing pain. For example, activities such as typing, sewing, or playing racquet sports can contribute to pain and carpal tunnel syndrome. If the wrist pain is accompanied by swelling and bruising, then the underlying cause is an injury. On the other hand, inability to move the hand and misshapen joints indicate a fracture.

The fracture can occur due to accident or osteoporosis. Other causes of pain in the wrists include the following:

  • Gout and pseudogout
  • Tendinitis
  • Arthritis
  • Sprains and strains

 

Do I need wrist surgery?

Unless you fracture the wrist in an accident, surgery is simply an option that your doctor could recommend when other treatments to reduce the pain and improve flexibility don’t work. You are a good candidate for the wrist surgery in the following instances:

  • Other treatments don’t work (including physical therapy)
  • The severity of pain aggravates
  • Mobility of the wrist decreases
  • The wrist problem affects the overall quality of life

 

Common wrist surgeries

Tendon repair

Tendon is defined as a tough cord of tissue which connects muscles to the bones. If tendons are damaged, surgery is a perfect solution to repair them and restore movement. During the tendon repair, the surgeon makes an incision in the wrist to locate the ends of the divided tendon and stitches them back together. The same procedure can be performed on different parts of the hand area, depending on the location of the damage.

Duration of the procedure itself depends on the type of affected tendon, but the recovery process can be quite lengthy because repaired tendons will be extremely weak until they make a full recovery. Generally, it can take up to three months for the repaired tendon to regain the previous strength.

Wrist fusion

This surgical procedure is primarily performed in cases wherein arthritis pain becomes so unbearable that other treatments don’t work anymore. A wrist fusion is also necessary after a person suffers a severe trauma to the wrist. The surgeon can fuse the wrist in many different ways. Although in the past, to perform this procedure a surgeon had to take a bone graft from the pelvis, today surgeons take a small amount of bone from the end of the radius bone instead.

The procedure usually lasts up to 90 minutes and can be done using:

  • General anesthesia
  • Local anesthesia

During the procedure, the surgeon removes the articular cartilage from each joint that will be removed. Your surgeon will, also, place a metal plate with screw holes on the back of the wrist. After the surgery, the patient has to wear an elbow-length cast for about six weeks. The stitches are removed in 10 to 14 days, even though your body absorbs most of them.

Wrist joint replacement

Wrist joint replacement isn’t as common as a joint replacement in the knee or hip, but it’s an option for individuals with painful arthritis to retain or recover wrist movements. Unlike a knee or hip joint replacement, this procedure can be performed as an outpatient procedure. The surgeon makes an incision on the back of the wrist and removes damaged parts of the wrist bones to replace them with artificial components.

After the procedure, a patient wears cast for a few weeks, then a splint for the next six to eight weeks.

Wrist fracture repair

A vast majority of wrist fractures include the scaphoid and the radius. In some cases, the small fragments of the bone stay within the joint after a fracture. The surgeon has to remove these fragments and to align bones and stabilize them with pins, screws, and wires. If stabilized internally, it’s called internal fixation. Naturally, if stabilized externally, it’s called external fixation.

ORIF/CRPP for distal radius fractures

More severe fractures call for more intense, and specialized surgical procedure, such as:

  • ORIF (open reduction internal fixation) – requires a large incision and placement of a screw or plate to stabilize the break
  • CRPP (closed reduction percutaneous pinning) – requires a small incision, the fracture is manipulated to the best position. Surgeon inserts pin to hold the broken bone together.

 

Other procedures

  • Osteotomy – bone is cut to shorten, lengthen, or change its alignment. The procedure is primarily conducted in order to “fix” the bone that healed incorrectly after a fracture
  • Synovectomy – removing the excess synovial membrane tissue in the wrist and fingers that may be causing pain and deformity
  • Proximal row carpectomy – three carpal bones in the wrist are removed to relieve pain

 

Recovery tips

Regardless of the type of wrist surgery you undergo, you should follow general guidelines which include:

  • Following doctor’s orders
  • Physical therapy
  • Protecting wrist from overuse using a hand splint
  • Perform recommended exercises regularly

The decision to go back to work depends on your condition, type of wrist surgery, type of work, and the healing process. You shouldn’t do it without the doctor who ca tell you whether it’s the right time to go back to work or not. For example, light activities can be resumed in 6 to 8 weeks, while heavy activities including sport after 10 to 12 weeks. To go back to work sooner rather than later, it’s necessary to follow doctor’s instructions.

Conclusion

Fractures, injuries due to accidents, arthritis, and other factors can create a major damage to the wrist, thus causing pain and limiting mobility. Wrist surgery is usually recommended to relieve the pain and regain movement when other treatments don’t help. It’s advised to follow doctor’s orders to recover properly.

 

References

http://www.mainlinehealth.org/orthopedics/treatments/surgical/hand-and-wrist
http://www.arthritisresearchuk.org/arthritis-information/surgery/hand-and-wrist-surgery/do-i-need-surgery.aspx
http://www.nhs.uk/conditions/tendonhand/Pages/Introduction.aspx
http://www.houstonmethodist.org/orthopedics/where-does-it-hurt/wrist/wrist-fusion/
http://orthoinfo.aaos.org/topic.cfm?topic=A00019