Name of the Procedure:

Open Treatment of Radiocarpal or Intercarpal Dislocation (also known as Open Reduction of Wrist Dislocation)

Summary

In layman's terms, this procedure involves surgically correcting a dislocation of the bones in the wrist. It may involve realigning one or more bones and ensuring they stay in the correct position to heal properly.

Purpose

This procedure addresses dislocations of the wrist, specifically the radiocarpal (between the radius and carpal bones) or intercarpal (between carpal bones) areas. The goal is to restore the normal alignment and function of the wrist, relieve pain, and prevent long-term complications such as instability or arthritis.

Indications

• Painful wrist dislocation
• Visible deformity of the wrist
• Inability to move or use the wrist normally
• Failed closed reduction (non-surgical alignment)
• Associated fractures

Preparation

• Patients may be instructed to fast for a certain period before the procedure.
• Medication adjustments may be necessary, especially for blood thinners.
• Diagnostic imaging like X-rays or MRI scans to assess the extent of the dislocation.
• Pre-operative blood tests and physical examination.

Procedure Description

1. The patient is given general anesthesia or regional anesthesia to ensure they are pain-free.
2. An incision is made over the dislocated area of the wrist.
3. The surgeon visualizes and assesses the dislocated bones.
4. The bones are realigned (reduced) to their normal anatomical positions.
5. Stabilizing hardware (such as pins, screws, or plates) may be used to maintain alignment.
6. The incision is closed with sutures or staples.
7. A sterile dressing is applied, and the wrist is usually immobilized with a splint or cast.

Duration

The procedure typically takes around 1 to 2 hours, depending on the complexity of the dislocation.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Radiology technician (if intraoperative imaging is needed)

Risks and Complications

• Infection
• Nerve or blood vessel damage
• Stiffness or reduced wrist motion
• Hardware-related issues such as migration or breakage
• Re-dislocation or improper healing
• Surgical bleeding or blood clots

Benefits

• Alignment and stabilization of the dislocated bones
• Relief from pain and deformity
• Improved wrist function and mobility
• Prevention of long-term complications

Recovery

• Initial immobilization with a cast or splint for several weeks.
• Pain management with medications as needed.
• Gradual return to normal activities guided by a physician or physical therapist.
• Regular follow-up visits for X-rays and monitoring healing.
• Potential physical therapy to regain wrist strength and mobility.
• Full recovery typically takes several months.

Alternatives

• Closed reduction (non-surgical realignment), though it may be less effective for severe dislocations.
• Conservative treatment with splinting and physical therapy, which may not fully address the problem.
• The pros of open treatment include a more reliable alignment and stabilization, while cons may include the risks associated with surgery.

Patient Experience

• Patients will be asleep or under sedation during the procedure and will not feel pain.
• Postoperative discomfort and swelling are common and can be managed with pain medications.
• It is important to keep the wrist elevated to reduce swelling.
• The patient might feel stiffness initially, but this should improve with time and physical therapy.