The wrist is one area of the body containing a lot of bones which are always moving. As would happen with any type of trauma or injury, extended use, wear and tear with age, or the development of arthritis can cause severe pain. Since you move your wrist to do just about everything you do with your hands and fingers, this pain can be incredibly debilitating.
An answer to the problem of severe wrist pain may be found in the form of joint fusion, also known as wrist fusion surgery. As with any type of fusion surgery, the goal is to eliminate the movement causing the pain, so there will be a loss of the up and down movement in the wrist. However, this is offset for our patients with the complete end to the pain being caused by this action.
There are different options in wrist fusion surgery, which will be determined in consultation with our orthopaedic surgeons. In general, the procedure includes attaching a metal plate, or sometimes a rod, directly to the bone with screws. This prevents the bones from moving while they fuse together to form a solid and immobile section.
In addition, a small amount of material grafted from your own bones may be used to stimulate the growth of the bones in the wrist to create the fused, solid area. This graft may come from the radius bone itself or it could come from your hip or pelvis. Depending on the type of procedure, you may be fully anesthetized, or just under local anesthesia to numb your arm and hand.
During this process, the plate or rod is attached to the radius, the bone in the arm on the inside, and across the back of the hand to the middle finger. This attachment prevents movement of the wrist, but still allows rotation of the hand and arm and movement of the fingers.
To assist with fusion of the bone, you will be in a cast for up to eight weeks, and then you will transition into a splint. During this time, you will start working with one of our physical therapists in specific exercises to build up strength and get used to using your hand again. Range of motion exercises will also aid in recovery, as well as gaining confidence in using your hand.
The duration of physical therapy is determined based on the progress of your fusion and the specifics of your recovery. The goal is to not just allow your wrist to heal, but also to learn new ways to use your wrist to prevent stress and decrease the risk of further related problems.