Name of the Procedure:

Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body

Summary

An arthrotomy of the wrist joint is a surgical procedure that involves opening the wrist to examine the structures inside, potentially taking a biopsy, and removing any loose or foreign bodies.

Purpose

The procedure addresses issues within the wrist joint such as persistent pain, unexplained swelling, joint infections, or the presence of loose bodies (e.g., bone fragments). The goals are to diagnose the specific problem, relieve symptoms, and improve wrist function.

Indications

• Chronic wrist pain unresponsive to other treatments
• Swelling or suspected infection in the wrist joint
• Presence of foreign bodies or cartilage fragments within the joint
• Diagnostic necessity for biopsy of wrist tissues
• Limited wrist mobility due to internal obstructions

Preparation

• Fasting for at least 8 hours before the procedure
• Adjusting medications as per doctor's advice (e.g., stopping blood thinners)
• Diagnostic tests such as X-rays, MRI, or CT scans to assess the wrist condition

Procedure Description

• The patient is given local or general anesthesia.
• An incision is made over the wrist joint.
• The joint capsule is carefully opened to expose the internal structures.
• The surgeon explores the joint, possibly taking biopsies and removing any loose bodies or foreign materials.
• The joint and the incision are then thoroughly cleaned and closed with sutures.
• A sterile dressing is applied to cover the surgical site.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

The procedure is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Scrub technician

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Nerve or blood vessel damage
• Joint stiffness or reduced range of motion
• Adverse reaction to anesthesia
• Need for further surgery if initial goals are not met

Benefits

• Relief from chronic pain and swelling
• Improved wrist function and mobility
• Accurate diagnosis of underlying issues
• Removal of obstructive loose bodies or foreign materials

Recovery

• Immobilization of the wrist with a splint or brace for a few weeks
• Pain management with prescribed medications
• Physical therapy to restore joint movement and strength
• Recovery time varies but usually spans 4 to 6 weeks
• Follow-up appointments to monitor healing and progress

Alternatives

• Conservative treatments like medications, physical therapy, and wrist supports
• Arthroscopy, a minimally invasive surgery using a small camera
• Steroid injections to reduce inflammation Pros and Cons:
• Conservative treatments have fewer risks but might not be as effective for severe conditions.
• Arthroscopy is less invasive but may not allow as thorough examination and treatment as arthrotomy.

Patient Experience

• Patients might feel drowsy or sore immediately after the procedure due to anesthesia.
• Post-operative pain managed with medications.
• Some swelling and limited wrist movement are normal initially.
• Discomfort should gradually decrease with proper care and physical therapy efforts.