The most common surgical method to fix a bone on your wrist bone when dealing with significant damage, arthritis, or instability is a wrist fusion, also known as arthrodesis.
Here's a breakdown of what wrist fusion entails:
What is Wrist Fusion?
Wrist fusion is a surgical procedure that joins two or more bones in your wrist together, effectively creating a single, solid bone. This eliminates motion between those bones. While it reduces wrist flexibility, it also alleviates pain and improves stability.
How Wrist Fusion Works:
The surgeon performs the following steps during a wrist fusion procedure:
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Cartilage Removal: The damaged cartilage between the bones that are to be fused is removed. Cartilage is the smooth tissue that allows bones to glide against each other, and its deterioration is a common source of wrist pain.
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Bone Grafting (Sometimes): A bone graft, either from your own body (usually the hip) or a donor, might be used to fill any gaps and promote bone growth and fusion. This isn't always necessary.
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Fixation: The bones are held together with hardware, such as plates, screws, or pins. These stabilize the wrist while the bones heal and fuse together. These devices generally stay in place permanently.
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Healing: Over time (typically several months), the bones will grow together, forming one solid bone mass. This eliminates movement at the fused joints and, consequently, the pain arising from those joints.
Types of Wrist Fusion:
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Complete Wrist Fusion (Total Wrist Arthrodesis): All the bones in the wrist are fused to the radius (the main bone in the forearm). This eliminates all wrist motion.
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Partial Wrist Fusion: Only some of the wrist bones are fused. This aims to relieve pain while preserving some wrist movement. The specific bones fused depend on the location of the arthritis or injury.
When is Wrist Fusion Recommended?
Wrist fusion is considered when other treatments, like medication, splints, and physical therapy, haven't provided sufficient relief from:
- Severe wrist arthritis (osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis).
- Wrist fractures that are unstable or have not healed properly (nonunion).
- Wrist instability due to ligament damage.
- Severe carpal tunnel syndrome (in rare cases, if other treatments fail and carpal instability is a contributing factor).
- Kienbock's disease (avascular necrosis of the lunate bone).
Recovery:
Recovery from wrist fusion typically involves:
- Immobilization: A cast or splint is worn for several weeks or months to protect the wrist while the bones fuse.
- Physical Therapy: Once the cast is removed, physical therapy helps regain strength and range of motion in the surrounding joints (fingers, elbow, shoulder).
- Pain Management: Pain medication is used to manage discomfort during the recovery period.
- Activity Restrictions: It is important to avoid heavy lifting or strenuous activities until your surgeon clears you to do so.
Wrist fusion is a significant surgical procedure, and it's essential to discuss the risks, benefits, and alternatives with your doctor to determine if it's the right option for you. Alternatives may include wrist replacement (arthroplasty) or other less invasive procedures depending on the specific condition.
