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Wrist Reconstruction Surgery

‘Wrist reconstruction’ can refer to a number of surgical procedures, including wrist ligament reconstruction, tendon transfer, wrist joint fusion, and any combination of these. Most commonly, it refers to a wrist joint replacement surgery.

Due to the versatility of its definitions, wrist reconstruction surgery may be used to treat a number of wrist conditions – arthritis, severe sprains, fractures, and recurring dislocations are just a few. If your wrist pain has not responded to nonoperative treatments, contact Orthopaedics SA for an expert assessment.

Wrist reconstruction can involve a number of different techniques, depending on why it’s being performed.

If you are undergoing a wrist reconstruction following a traumatic injury, your surgery might involve repairing torn ligaments and tendons, pinning broken bones into position, or replacing severely damaged structures with grafts or prosthetics. Alongside physical repairs, your wrist reconstruction surgery may include the following:

·      Synovectomy – removing some of the wrist’s synovial tissue

·      Joint fusions – securing one or more bones in the wrist together so that they heal to become a single bone

·      Debridement – flushing the joint to remove loose cartilage or bone fragments

Wrist joint replacement is still an uncommon procedure, though ongoing study is gradually making it more successful and more readily available. If your wrist condition is not improving with nonoperative care, ask your doctor for a referral to Orthopaedics SA.

All surgery includes some risks. Along with those that apply to all surgeries (scarring, bleeding, infection, etc.), the risks of wrist reconstruction can include:

·      Ongoing pain

·      Nerve damage

·      Ruptured tendons and ligaments

·      Seroma (fluid building up in the joint)

·      Prosthetics becoming loose (if they are used in your surgery)

When your Orthopaedics SA surgeon evaluates your suitability for surgery, they consider your likelihood of complications and successful healing as well as whether the surgery can be performed. You can trust that they will consider all options and only recommend reconstructive surgery on your wrist if they believe it is best for your health.

As wrist reconstruction surgery is generally recommended when the wrist is very damaged, there are very few viable alternatives.

If your wrist condition is not currently serious, your doctor may recommend conservative management options instead of reconstructive surgery. These may include taking over-the-counter anti-inflammatory painkillers (like Nurofen or Advil), getting steroid injections into your wrist joint, and using a splint or wrist brace.

Total wrist joint replacement may be considered, although current wrist prosthetics do not have the same success rates as hip or knee replacements. If you want to maintain strength and lifting ability in your hand, you may consider wrist fusion instead.

Rather than replacing or repairing damaged bones, wrist joint fusion involves attaching them to each other so they heal into a single structure. The joint produces less pain because it has less ability to move, with the disadvantage of very limited mobility afterward.

Most patients remain in the hospital for around 2-3 days after a wrist construction surgery. The amount of time spent there can vary according to the severity of your injury, whether you have surgical complications, and the speed at which your own body heals.

When your care team feels you are ready, they will discharge you with aftercare instructions and a prescription for pain-relievers. Be sure to take painkillers on the schedule recommended by your team (rather than only when you feel you need them), as pain is far easier to manage before it becomes out of control.

You will need to wear a splint for several weeks after surgery, giving the bones and soft structures time to heal. You can take the splint off after this period to engage in light activities as directed by your surgeon, though you may need to continue wearing it overnight for several months. Your surgeon might also recommend elevating your wrist by wearing a sling.

Different types of wrist reconstruction surgery take different amounts of time to heal fully. If you had a wrist joint fusion, you can expect full recovery in about three months. Recovering from a wrist tendon repair can take roughly the same amount of time, though your recovery time may vary if multiple ligaments were repaired or if a fracture is present.

Your surgeon at Orthopaedics SA will speak to you about your expected recovery before performing any type of wrist reconstruction procedure, and will only perform one if they feel confident that it will improve your health. For individualized information and world-class care, ask for a referral to Orthopaedics SA.

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