Hand & Wrist Surgery, Orthopedic Surgery

October 28, 2020

Wrist Fusion for Arthritis & Injury


Wrist fusion, or arthrodesis, is the immobilization of the wrist joint achieved by fusing the small bones of the hand or wrist to the radius, one of the bones in the forearm.

Why Might I Need Wrist Fusion Surgery?
The most common reasons for performing wrist fusion surgery are severe arthritis or injury to the wrist joint that causes debilitating pain that interferes with daily living. The solution often involves fusing the small bones of the wrist joint to alleviate pain caused by grinding and destabilization in the area.

Pain and destabilization in the wrist can lead to weakness and the inability to grip and use the hand correctly. In severe cases of wrist arthritis, the area can become deformed, with bones becoming misaligned. Wrist fusion can prevent additional deformity and help return the wrist to its proper alignment.

In some instances, injury to the wrist area can destabilize the joint and cause rubbing and inflammation that leads to chronic pain. Wrist fusion surgery can help prevent the bones from rubbing together, thereby eliminating the source of the pain.

Will I Be Able to Move My Wrist After Fusion Surgery?
In a wrist fusion surgery, the surgeon joins the radius, the carpal bones of the wrist, and the small bones in the hand (called the metacarpals) together into one unit so that they will eventually knit into one longer bone. He or she will keep the ulna bone, which is the other bone in the forearm, separate so that you will still be able to rotate the palm of your hand. However, you will not be able to bend your hand at the wrist after wrist fusion surgery.

While you will lose some range of motion after wrist fusion surgery, you will no longer have pain, and you will regain the lost strength in your wrist over time. You will once again be able to grip and have strong flexion in your hand. If strength is essential for your line of work, wrist fusion is an excellent option. If you need a full range of movement, however, talk to your doctor or surgeon about other solutions for your wrist, such as joint replacement. The surgeons at Arkansas Surgical Hospital can help you decide on the best option for your level of wrist pain and the range of movement you need to maintain.

What Happens During Wrist Fusion Surgery?
During wrist fusion surgery, bone grafts are used to connect the different sections of bone to each other. In some cases, your surgeon will take a graft from your pelvis, although he or she may also get bone from a bone bank.

Wrist fusion surgery is usually done under general anesthesia and takes about 90 minutes. Once you are sedated, an incision will be made down your wrist, avoiding nerves and blood vessels. Tendons and muscles will be moved aside, and cartilage will be removed from the joints to be fused. When the grafts are put in place, a metal plate and screws will be installed to hold the wrist in place. The plate runs from the radius to the metacarpal bone, holding everything in position while the bone grafts fuse. It will stay in place permanently unless injury or another condition later causes a problem.

What Happens After Wrist Fusion Surgery?
After wrist fusion surgery, you’ll need to wear a cast up to your elbow for up to six weeks. This holds the wrist in place as the bones fuse. About a week after surgery, you’ll have your first checkup. Stitches will be removed about two weeks after surgery (unless dissolving sutures have been used). For several weeks following surgery, your surgeon will x-ray your wrist to make sure the area is healing correctly and the bones are fusing cleanly.

There will be some post-surgery pain, but your surgeon will prescribe pain medication for the first few days. After that, over-the-counter medication will suffice. When you get home, keep your arm elevated above your heart for several days to minimize swelling and pain. When you sleep, prop your arm up on pillows or a stack of blankets.

After the cast is removed, you will wear a removable splint that makes it easier to shower, bathe, and exercise. At first, your fingers will feel stiff, but proper therapy and exercise will help and is crucial to your recovery.

How Long Does it Take to Recover After Wrist Fusion Surgery?
Recovery after wrist fusion surgery involves therapy and exercise to restore flexibility to your fingers and strength to your hand and arm. The first few weeks after surgery will focus on minimizing any remaining pain and inflammation. Your physical therapist may use therapies such as massage to ease your discomfort and alleviate muscle spasms.

The next phase of recovery will focus on increasing the range of motion of your wrist and finger joints. A variety of exercises will be designed for you that focus on ways to strengthen your wrist and hand, improve your range of movement, and help you perform the tasks of daily living, as well as any tasks required for you to continue working in your chosen career. You will also be taught ways to compensate for your inability to bend your wrist and how to avoid future injuries or problems with your wrist. Developing fine motor skills is the final phase of your recovery.

Throughout this process, your dedication to at-home exercise is crucial to the healing process and complete recovery. The success of your wrist fusion can hinge upon your dedication to working with your surgeon and physical therapist before, during, and after your procedure.

Is Wrist Fusion Surgery Right for Me?
If you believe that wrist fusion may help relieve your arthritis or wrist injury pain, Contact Arkansas Surgical Hospital at (877)-918-7020 to schedule an appointment with one of our orthopedic surgeons to learn more. A consultation, x-rays, and physical examination will help determine whether wrist fusion surgery is the best option for you.

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