Name of the Procedure:

Arthrodesis, carpometacarpal joint, digit, other than thumb, each

Summary

Arthrodesis of the carpometacarpal joint, excluding the thumb, is a surgical procedure that involves fusing two or more bones in the wrist and hand to relieve pain and improve stability.

Purpose

This procedure addresses joint pain and instability often caused by arthritis, trauma, or degenerative conditions. The goal is to provide pain relief, enhance joint stability, and improve hand function.

Indications

• Persistent joint pain not relieved by medication or conservative treatments
• Severe arthritis affecting the carpometacarpal joints, excluding the thumb
• Joint instability due to trauma or degenerative conditions
• Patients who have exhausted other non-surgical treatment options

Preparation

• Pre-operative fasting as instructed by the healthcare provider
• Adjustment or cessation of certain medications, such as blood thinners
• Pre-surgical diagnostic tests, such as X-rays or MRI, to assess the joint condition

Procedure Description

1. The patient is positioned and the surgical area is cleaned and sterilized.
2. Anesthesia is administered, usually regional or general anesthesia, depending on the case.
3. An incision is made over the affected carpometacarpal joint.
4. Damaged cartilage is removed, and the bones are prepared for fusion.
5. The bones are aligned and held together using screws, plates, or wires.
6. The incision is closed with sutures and covered with a sterile dressing.
7. The hand and wrist are immobilized with a cast or splint to ensure proper healing.

Duration

Typically, the procedure takes 1 to 2 hours.

Setting

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

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection
• Blood clots
• Nerve damage
• Nonunion or delayed union of the fused bones
• Stiffness or loss of range of motion in the adjacent joints

Benefits

• Significant pain relief
• Improved joint stability
• Enhanced hand function
• Long-term solution for severe joint conditions

Recovery

• Initial immobilization with a cast or splint for several weeks
• Pain management with prescribed medications
• Follow-up appointments to monitor healing
• Gradual return to activities, with physical therapy to regain strength and mobility

Alternatives

• Non-surgical treatments: physical therapy, medications, joint injections
• Joint replacement surgery
• Pros of alternatives: less invasive
• Cons of alternatives: may not provide long-term relief or stability

Patient Experience

• During the procedure: Anesthesia ensures the patient does not feel pain
• After the procedure: Mild to moderate pain managed with medications
• Immobilization may cause discomfort. Physical therapy aids in recovery and adaptation.