Name of the Procedure:

Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)

Summary

Arthrodesis of the wrist with an iliac or other autograft involves surgically fusing the bones in the wrist to alleviate pain and stabilize the joint. Bone graft material, often taken from the patient's iliac crest (part of the pelvic bone), is used to facilitate the fusion.

Purpose

Medical Condition:

• Severe arthritis
• Wrist instability or deformity
• Chronic wrist pain not responsive to conservative treatments

Goals:

• Alleviate pain
• Stabilize the wrist joint
• Improve function

Indications

• Persistent wrist pain unrelieved by medications or physical therapy
• Severe arthritis or joint damage
• Non-union fractures of the wrist
• Previous unsuccessful wrist surgery

Preparation

• Fasting for a specified period before surgery
• Adjustments to current medications as guided by the physician
• Blood tests and imaging studies (e.g., X-rays, MRI)
• Preoperative assessment to evaluate overall health

Procedure Description

• The patient is administered general anesthesia.
• An incision is made at the wrist to access the joint.
• The damaged cartilage and a small portion of bone are removed.
• Bone graft material from the iliac crest or another site is harvested.
• The graft material is placed between the wrist bones to promote fusion.
• Metal plates, screws, or pins may be inserted to stabilize the bones.
• The incision is closed with sutures and dressed.

Duration

The procedure typically takes 2-4 hours.

Setting

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

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

Common Risks:

• Infection
• Bleeding
• Pain at the graft site

Rare Risks:

• Non-union (failure of the bones to fuse)
• Nerve or blood vessel damage
• Complications from anesthesia

Benefits

• Significant pain relief
• Improved wrist stability
• Enhanced ability to perform daily activities

Recovery

• Immobilization of the wrist in a cast or splint for several weeks
• Physical therapy to regain strength and flexibility
• Regular follow-up appointments to monitor healing
• Complete recovery may take several months

Alternatives

• Non-surgical treatments (e.g., medications, injections, physical therapy)
• Other surgical options like partial wrist fusion or replacement
• Pros: Less invasive, shorter recovery times for non-surgical options
• Cons: May not provide the same level of pain relief or stability as arthrodesis

Patient Experience

During the Procedure:

• The patient will be under general anesthesia and feel no pain.

After the Procedure:

• Pain management with medications
• Some discomfort and swelling at both the wrist and graft sites
• Gradual return to normal activities with specific restrictions
• Assistance with daily tasks may be required during initial recovery stages