After Care and Therapy
Total Wrist Fusion
Total Wrist Fusion is an operation which is carried out in severe arthritis of the wrist joint. The wrist joint can be affected in people with rheumatoid arthritis (RA) and sometimes osteoarthritis (OA). Osteoarthritis usually results from a previous fracture or ligament injury of the wrist (secondary OA). Arthritis causes pain, restricted motion and disability of hand. In severe cases when these symptoms cannot be controlled by medications, a wrist fusion is performed. This takes away the pain and improves function of hand. As wrist movements are lost there are slight restrictions in carrying out few activities. The overall improvement in pain and strength makes it a very worthwhile operation. You will be referred to Occupational Therapy (OT) for pre-op education and wrist splint to experience wrist fusion before the operation is performed.
The operation is performed under general anaesthesia (being asleep) or a regional nerve block (when the arm is frozen). It is necessary to stay one or two nights in the hospital to get the pain and swelling under control.
You will be discharged with a plaster slab extending from below the elbow up to the knuckles of fingers. The arm will be in a sling to keep swelling under control. Keep arm elevated as mush as possible. You will require some pain killers for a few days.
0 – 6 Weeks
At your first clinic visit 2 weeks after operation, the plaster will be changed and stitches will be removed. An x-ray is carried out to check the position of fusion. A new plaster cast will be applied. You will be encouraged to exercise your fingers and thumb and also move your elbow.
6 – 12 Weeks
Your next clinic visit will be at 6 weeks from operation. The plaster will be removed. It may be necessary to wear a removable splint for a further 2-4 weeks. You will be referred for Therapy to help swelling and for mobilisation of joints of hand and gradual strengthening.
After 12 Weeks
By now the swelling will have settled and you should be able to have good grip strength. Another x-ray is carried out at this stage to check for healing. If all has gone well, you will be discharged. With regular exercise and use, your wrist will continue to get stronger in the next 6-12 months.