Name of the Procedure:

Arthrotomy, wrist joint; with biopsy
Common name(s): Wrist joint surgery with biopsy, Wrist joint exploration and biopsy
Medical term: Arthrotomy

Summary

Arthrotomy of the wrist joint with biopsy is a surgical procedure that involves making an incision into the wrist joint to perform an internal examination and taking a tissue sample (biopsy) for further analysis.

Purpose

This procedure addresses issues like persistent pain, swelling, or suspected infections or tumors in the wrist joint that are not conclusively diagnosed with non-invasive methods. The goal is to diagnose the underlying cause of wrist joint abnormalities and formulate an appropriate treatment plan.

Indications

• Chronic wrist pain that does not improve with conservative treatments
• Unexplained swelling or inflammation of the wrist
• Suspected infection or septic arthritis
• Suspected tumors or other abnormal growths in the wrist joint
• Need for a definitive diagnosis when imaging tests like X-rays or MRIs are inconclusive

Preparation

• The patient may need to fast for several hours before the procedure.
• Blood tests and imaging studies (X-rays, MRI) may be conducted prior to the surgery.
• Medications may need to be adjusted or temporarily discontinued.
• The patient will be advised to arrange for someone to drive them home post-procedure, as sedation or anesthesia may be used.

Procedure Description

1. The patient is positioned on the operating table, and the wrist is sterilized.
2. Local or general anesthesia is administered to ensure the patient is comfortable.
3. A small incision is made over the wrist joint.
4. The surgeon carefully inspects the internal structures of the wrist joint.
5. A biopsy sample is taken from the suspected area of abnormality.
6. The incision is closed with sutures or surgical staples.
7. A sterile dressing is applied to cover the wound.

Duration

The procedure typically takes between 45 minutes to 1 hour, depending on the complexity of the case.

Setting

Arthrotomy of the wrist joint with biopsy is typically performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist or anesthetist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection at the surgical site
• Bleeding
• Nerve damage leading to numbness or weakness
• Adverse reactions to anesthesia
• Prolonged pain or discomfort To manage complications, the healthcare team will monitor the patient closely and provide necessary treatments.

Benefits

• Accurate diagnosis of the underlying cause of wrist symptoms
• The ability to formulate a precise treatment plan based on biopsy results
• Relief from symptoms when an effective treatment is applied, often shortly following the procedure

Recovery

• The patient will receive post-operative instructions, such as keeping the incision dry and taking prescribed medications.
• The recovery period typically ranges from a few days to a couple of weeks, depending on individual healing rates.
• Activities involving the wrist may be restricted to allow proper healing.
• Follow-up appointments are essential to monitor recovery and discuss biopsy results.

Alternatives

• Non-surgical diagnostic tests like MRI, CT scan, or ultrasound
• Needle biopsy, which is less invasive but might not be diagnostic
• Conservative management, including physical therapy, medications, and rest Pros and cons of alternatives should be discussed with a healthcare provider to determine the best course of action.

Patient Experience

During the procedure, the patient will not feel pain due to anesthesia, although some pressure or manipulation might be felt if under local anesthesia. Post-procedure, there may be mild to moderate discomfort and swelling in the wrist. Pain management options, including medications, will be provided to ensure comfort.