Our Summary

This research article talks about a surgical procedure called partial wrist arthrodesis (PWA), which is commonly used to treat wrist conditions caused by degeneration or injury. The author of the study has performed 39 of these procedures, using different techniques such as four-corner fusion (4CF), two-corner fusion, three-corner fusion, and others.

Out of all the procedures, there were eight cases that needed to be revised, including four where the bone did not fully heal. However, after revision surgery, all the procedures that were assisted by arthroscopy (a minimally invasive surgical procedure on a joint) healed satisfactorily.

The article also gives advice on how to avoid mistakes during surgery and weighs the advantages and disadvantages of different surgical techniques, like open versus arthroscopic procedures, and the use of screws versus Kirschner wires (a type of orthopedic wire used in surgery).

FAQs

  1. What is partial wrist arthrodesis (PWA) and when is it used?
  2. What are the different surgical techniques for partial wrist arthrodesis?
  3. What are the pros and cons of open versus arthroscopic techniques and screws versus Kirschner wires in wrist arthroscopy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about wrist arthroscopy is to follow the post-operative care instructions carefully. This may include keeping the wrist elevated, regularly icing the area, and doing prescribed exercises to aid in recovery and prevent stiffness. Additionally, it is important to attend all follow-up appointments to ensure the wrist is healing properly.

Suitable For

Wrist arthroscopy is typically recommended for patients with degenerative or posttraumatic wrist conditions such as scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC). Patients who may benefit from wrist arthroscopy include those with chronic wrist pain, limited wrist motion, and instability due to conditions such as ligament tears, cartilage damage, or arthritis. Additionally, patients who have not responded to conservative treatments such as physical therapy, medications, and corticosteroid injections may be candidates for wrist arthroscopy.

Timeline

Before wrist arthroscopy:

  1. Patient presents with symptoms such as wrist pain, stiffness, swelling, and limited range of motion.
  2. Patient undergoes physical examination, imaging tests such as X-rays and MRI, and possibly conservative treatments such as rest, immobilization, and physical therapy.
  3. If conservative treatments are unsuccessful, patient may be recommended for wrist arthroscopy to diagnose and treat the underlying wrist condition.

After wrist arthroscopy:

  1. Patient undergoes wrist arthroscopy procedure under anesthesia, which involves inserting a small camera and instruments into the wrist joint through small incisions.
  2. Surgeon performs necessary repairs or procedures, such as removing damaged tissue, repairing ligaments, or performing a wrist fusion.
  3. Patient may experience mild pain, swelling, and stiffness in the wrist following the procedure.
  4. Patient undergoes post-operative care, including pain management, physical therapy, and follow-up appointments with the surgeon.
  5. Patient gradually resumes normal activities and experiences improved wrist function and reduced pain over time.

What to Ask Your Doctor

  1. What specific condition do I have that requires wrist arthroscopy?
  2. What are the expected outcomes of the procedure?
  3. What are the potential risks and complications associated with wrist arthroscopy?
  4. How long is the recovery process and what can I expect in terms of pain and mobility?
  5. Are there any alternative treatment options that I should consider?
  6. How many wrist arthroscopies have you performed and what is your success rate?
  7. What is the difference between open wrist fusion and arthroscopic assisted wrist fusion?
  8. Will I need any additional procedures or treatments after the wrist arthroscopy?
  9. How long will the effects of the wrist arthroscopy last?
  10. Are there any specific post-operative instructions or precautions that I should follow?

Reference

Authors: Baur EM. Journal: Hand Clin. 2017 Nov;33(4):735-753. doi: 10.1016/j.hcl.2017.07.013. PMID: 28991585