Name of the Procedure:

Arthrodesis, wrist; limited, without bone graft (e.g., intercarpal or radiocarpal)

Summary

Arthrodesis of the wrist, also known as wrist fusion, is a surgical procedure where certain bones in the wrist are permanently joined together to alleviate pain and improve stability. This specific type involves fusing specific parts of the wrist, such as between the carpal bones or between the radius and carpal bones, without using a bone graft.

Purpose

Wrist arthrodesis is typically performed to:

• Alleviate chronic pain due to arthritis or injury.
• Stabilize a dysfunctional joint.
• Improve the function of the wrist for improved quality of life.

Indications

This procedure is usually recommended for:

• Chronic wrist pain that has not responded to non-surgical treatments.
• Severely damaged or arthritic wrist joints.
• Some types of wrist fractures or joint instability.
• Specific conditions such as rheumatoid arthritis, osteoarthritis, or post-traumatic arthritis.

Preparation

• Patients may need to fast for several hours before the surgery.
• Medication adjustments may be necessary, especially if the patient is taking blood thinners.
• Pre-operative tests may include blood work, X-rays, and an evaluation of the patient's overall health.

Procedure Description

1. Anesthesia is administered, typically general anesthesia to ensure the patient is asleep and pain-free during the procedure.
2. An incision is made over the affected area of the wrist.
3. The affected bones and joint surfaces are cleaned and prepared.
4. The bones to be fused are aligned correctly, and screws, wires, or plates are used to hold them in place.
5. The incision is closed with sutures or staples, and a bandage or splint is applied to protect the area.

Duration

The surgery typically takes 2 to 3 hours.

Setting

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

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist
• Surgical technician

Risks and Complications

Common risks include:

• Infection
• Bleeding
• Blood clots
• Nerve damage Less common complications may include:
• Failure of the bones to fuse properly
• Persistent pain
• Limited wrist mobility

Benefits

• Significant reduction or elimination of wrist pain
• Improved stability and strength in the wrist joint
• Enhanced ability to perform daily activities

Recovery

• Post-procedure, the wrist is usually immobilized with a cast or splint for several weeks.
• Pain management will be provided through medications.
• Physical therapy may be recommended to aid recovery.
• Full recovery and return to normal activities can take several months.
• Follow-up appointments are necessary to monitor healing.

Alternatives

• Non-surgical treatments such as physical therapy, medications, or corticosteroid injections.
• Wrist arthroplasty (joint replacement).

Pros of alternatives:

• Less invasive
• Shorter recovery times

Cons of alternatives:

• May not provide permanent relief
• May not be suitable for severe cases

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel any pain. Post-procedure, there may be discomfort and pain, which can be managed with medications. The wrist will need to be kept immobile for some time, and there may be restrictions on activities until recovery is complete.