Total Wrist Fusion
Fusion simply means making the joint completely stiff or to make the bones of the wrist to join together. It is a very successful operation for advanced arthritis of the wrist joint. Patients who have a wrist fusion can carry out most functions comfortably as the pain is totally relieved. Finger movements are still possible and the grip strength improves. Rotation of the forearm also is better after wrist fusion and although wrist movements are no longer possible, patient satisfaction is generally very good.
Most patients who need wrist fusion have Rheumatoid arthritis or one of the other varieties of arthritis. The joint is severely damaged leading to pain and disability and even basic tasks are impossible to carry out. In the early stages of arthritis, medications often control symptoms well. Sometimes operations like synovectomy may improve the wrist function for a year or two. If the arthritis has advanced and there is significant joint damage causing pain and disability then the choice is to undergo either Total wrist fusion or Wrist replacement.
Wrist fusion is safer as success is long term (permanent). Fusion is achieved by a metal plate and screws or simply pins. Patients are kept in hospital for one or two nights. Wrist is held in plaster usually for 4 - 6 weeks. There is a very small risk of infection and non-union, which may mean re-operation. This risk is about 2%. Risks of tendon damage are very low. Long term patient satisfaction is excellent.
Consultant Hand Surgeon
FRCS (Trauma & Orth)