After Care and Therapy
SLAC operation is performed when the wrist joint has been affected by severe arthritis often as a result of a previous injury. This injury could be a type of wrist fracture or ligament injury many years before. If the healing had not been perfect then this leads to arthritis in wrist joint years later causing pain, restricted motions and disability.
If the disability is severe then operation is performed to help pain and improve function in the wrist joint. The scaphoid bone which is often very severely damaged is removed and the other small wrist bones are fused together. It is therefore called a partial wrist fusion as it preserves some wrist motion unlike total wrist fusion.
The operation is carried out under General anaesthetic (when you are asleep) or a Regional nerve block (when only the arm is frozen). Mostly the operation is done as a day case procedure unless there are medical reasons to keep you in hospital overnight such as diabetes etc.
0 – 4 Weeks
You will be discharged home with a back slab (half plaster) extending from below the elbow up to the knuckles of fingers. The arm will be in a sling. You will require some pain killers for a few days and also to keep the arm elevated to minimise swelling. Swelling of the hand is expected after this operation and starts to reduce after a week.
You will be seen in clinic for a follow up at 2 weeks when the plaster will be changed and stitches will be removed. An x-ray will be performed to check for the position of fusion. A new plaster is applied. You will be advised to keep the arm elevated and exercise your fingers and thumb as much as possible and also exercise your elbow.
4 – 8 Weeks
Your next clinic visit will be at 4 weeks from operation and your plaster will be removed. A removable splint will be provided to you, which you will wear most times except when carrying out exercises. You are advised to wear splint at nights as well. You will now be referred to physiotherapy for supervised exercises and gradual strengthening of the wrist joint.
8 – 12 Weeks
You will continue exercises under the supervision of the occupational therapist. It is expected that by 8 weeks, swelling will have settled. The expected motion in the wrist will be about 30 degrees in both directions (60 degrees in total). You should be able to make full fist with good strength and turn your arm round comfortably. You can now stop the use of splint. At your next clinic appointment (12 weeks from operation), an x-ray will be performed to check healing.
If all has gone well you will be discharged. With regular exercise and use, your wrist will continue to improve in the next 12 months.