After Care and Therapy
Total Wrist Replacement
Total Wrist Replacement (TWR) is done for end stage (very severe) arthritis. Most of these patients have Rheumatoid Arthritis (RA) which has affected many joints. If there is severe pain and disability then an artificial wrist joint replacement is one option. This is good for pain relief and there is significant improvement in function of the hand. The operation is mostly done under a General Anaesthesia (being asleep) or sometimes a regional nerve block (when the arm is frozen). You will require one to two night hospital stay. Some swelling of hand is expected and you will be asked to keep the hand elevated as much as possible. You will require some pain killer in the few days after operation.
0 – 6 Weeks
You will be discharged with you hand in a half plaster slab extending from below the elbow to the knuckles of the fingers. A sling will also be provided to keep the hand elevated. You should exercise your fingers and thumb fully and also move your elbow. Your first clinic appointment will be in 2 weeks when the plaster will be removed and wound will be checked. Stitches will be taken out. An x-ray will be performed. You will then be given a removable splint for your wrist. You will also be referred to Therapy to help mobilise the wrist. The splint should be worn most of the time only to be taken off during exercise sessions. You will be advised to gently move your wrist in all directions, exercise your fingers to make a fist and also turn your arm. Stretching of the wrist will be performed by the therapist but only after 4 weeks of operation. You should continue to wear the splint in between doing the exercises.
6 -12 Weeks
Your next clinic appointment will be in 6 weeks. Splint can now be discarded. You should continue to exercise the wrist yourself. It is expected that you will be able to move your wrist through a total range of 60 degrees. With continued use and exercise your wrist will continue to improve in the next 6-12 months. You will be seen again in 6 months for a further x-ray. It is usual to be seen every year thereafter.