Is wrist operation right for you?
Wrist surgery is an umbrella term that covers a range of procedures designed to treat injuries, conditions, and disorders that impact the wrist joint and the tissues around it. The goal of any operation on the wrist is to reduce pain, restore function, and improve your overall quality of life.
This article will give you a broad overview of wrist surgeries, including the types of procedures that are commonly performed. We’ll also cover how to prepare for surgery, what recovery might look like, and the potential complications that you should discuss with your healthcare team.
Understanding the benefits and risks of any wrist operation is critical to making an informed decision about your care. This information, combined with the advice of a qualified medical professional, will help you determine the best course of action for your specific situation.
Understanding the Wrist
The wrist is a complicated piece of equipment. When it’s working as it should, we hardly give it a thought. But when injury or illness strikes, it can sideline us from doing the things we enjoy.
Anatomy of the Wrist
The wrist is made up of eight small carpal bones that connect to the radius and ulna bones of the forearm. Ligaments connect those bones to each other, and tendons connect the muscles of the forearm to the bones of the hand.
Nerves and blood vessels also pass through the wrist, providing sensation and circulation to the hand and fingers. The median and ulnar nerves are two major nerves that travel through the wrist.
Common Wrist Conditions
Here are some of the most common conditions that can affect the wrist:
- Carpal tunnel syndrome. This happens when the median nerve gets compressed inside the carpal tunnel, leading to pain, numbness, and tingling in the hand and fingers.
- Arthritis. Osteoarthritis and rheumatoid arthritis can both affect the wrist, causing pain, swelling, and stiffness.
- Ligament tears and TFCC injuries. Trauma or overuse can cause tears in the ligaments of the wrist or injuries to the triangular fibrocartilage complex (TFCC), leading to wrist instability and pain.
Types of Wrist Surgery
If you and your doctor have decided that surgery is the best path forward, it’s helpful to understand the different procedures that are available. Here’s a rundown of some of the most common types of wrist surgery:
Wrist Arthroscopy
Wrist arthroscopy is a minimally invasive procedure in which a surgeon uses a small camera (called an arthroscope) along with tiny surgical instruments to see inside the wrist joint and repair damaged tissues.
Arthroscopy may be recommended if you have wrist pain, a ganglion cyst, ligament tears, TFCC tears, a wrist fracture, or arthritis in the wrist.
The advantage of arthroscopy is that it’s minimally invasive, leading to a faster recovery. However, it may not be the right choice for every condition.
Carpal Tunnel Release Surgery
Carpal tunnel release surgery eases the symptoms of carpal tunnel syndrome by cutting the transverse carpal ligament. This releases pressure on the median nerve.
If nonsurgical treatments haven’t helped your carpal tunnel syndrome, your doctor may recommend surgery.
There are several different surgical techniques:
- Open release: The surgeon makes an incision about 2 inches long.
- Endoscopic or ultrasound-guided release: The surgeon makes an incision only about a half-inch long.
Wrist Fusion
Wrist fusion (also called arthrodesis) involves joining the bones of the wrist together. This eliminates motion in the wrist and reduces pain.
Wrist fusion may be recommended if you have severe wrist arthritis, wrist instability, or a painful nonunion fracture.
After wrist fusion, you can expect to spend a few days in the hospital and wear a cast for 6 to 8 weeks.
Wrist Joint Replacement (Arthroplasty)
Wrist joint replacement involves removing the damaged wrist joint and replacing it with an artificial one.
If you have severe wrist arthritis and wrist fusion isn’t a good option for you, your doctor may recommend wrist joint replacement.
After wrist joint replacement, you’ll likely spend a night in the hospital. Full recovery may take several months.
Preparing for wrist surgery
If you and your doctor have decided that wrist surgery is the next best step, there are a few things you can do to prepare.
Medical evaluation and pre-operative testing
Your surgeon will want to conduct a thorough medical evaluation, including a physical exam and a review of your medical history, to make sure you’re healthy enough for the procedure and to identify any potential risks.
You’ll likely have some imaging tests performed, such as X-rays, MRI, or CT scans, so the surgeon can get a good look at your wrist joint and the tissues around it.
Medications and lifestyle considerations
It’s important to give your surgeon a complete list of all the medications you’re taking, including prescription and over-the-counter drugs, as well as any supplements.
If you smoke, now is definitely the time to quit. Smoking slows healing and raises the risk of complications from surgery.
Practical preparations
Think about how you’ll get to and from the hospital. You’ll also need to arrange for someone to help you out around the house while you recover.
Before your surgery, take a look around your home and see if there are any changes you can make to get around easier and do things even if you can’t use your hand very well.
What happens during wrist surgery?
There are a few things you can expect when you undergo wrist surgery:
Anesthesia
Depending on the type of surgery you’re having and what you prefer, you’ll be given either general anesthesia, which will put you to sleep, or regional anesthesia, also known as a nerve block, which will numb the area being operated on.
Surgical Techniques
The surgeon will make one or more incisions to get to the wrist joint or the tissue around it.
Then, they’ll repair or reconstruct the damaged tissue using stitches, grafts, or implants.
Closure
The incisions will be closed with sutures, and a sterile bandage or dressing will be applied to the area.
Post-operative care and recovery
The care you receive after your wrist surgery is key to a successful outcome. Here’s what you can expect during your recovery.
Immediate post-operative care
- Pain Management: You’ll likely be prescribed pain medication to help you manage any discomfort after the surgery. Take it as directed.
- Wound Care: Keeping your incision clean and dry is vital to preventing infection. Follow your doctor’s instructions carefully when changing the dressing.
- Elevation and Immobilization: Elevating your hand helps to reduce swelling. You’ll probably have a splint or cast to keep your wrist still, which aids in healing.
Rehabilitation
- Physical Therapy: This is a crucial part of your recovery. A physical therapist will guide you through exercises to help you regain strength, flexibility, and range of motion in your wrist and hand.
- Exercises: Doing the exercises your therapist prescribes regularly will help prevent stiffness and encourage healing.
- Splinting: You may need to continue wearing a splint during rehab to protect your wrist and give it the support it needs to heal properly.
Monitoring for complications
- Signs of Infection: Keep an eye out for signs of infection, like fever, redness, swelling, or any discharge from the incision. If you notice any of these, contact your doctor right away.
- Nerve Damage: Report any new or worsening numbness, tingling, or weakness in your hand or fingers to your healthcare provider. This could indicate nerve damage.
Recovery timeline
- Varies by procedure: How long it takes to recover depends on the type of surgery you had and your individual healing process.
- Gradual return to activities: Don’t rush back into your normal activities. Follow your healthcare provider’s instructions for a gradual return to avoid re-injury.
What are the risks?
Like any surgery, wrist operations carry the risk of infection, bleeding, and negative reactions to anesthesia.
Specific risks associated with wrist surgery include nerve damage, tendon damage, stiffness, and the failure of the repair. These complications can affect your hand and wrist function, potentially requiring further treatment.
Before your procedure, your surgeon should explain all potential risks and complications, answer your questions, and help you decide if surgery is the right option.
Closing Thoughts
Wrist surgery covers many different procedures for a wide range of wrist problems. Whatever the reason for your surgery, remember that careful planning, following your doctor’s instructions after the operation, and actively participating in rehabilitation are essential for the best possible outcome.
The right treatment for your wrist condition depends on your individual needs and preferences, so it’s important to have a thorough discussion with a qualified healthcare provider to decide on the best course of action. They can help you understand the risks and benefits of each option and create a plan that’s tailored to you.