Houston Methodist. Leading Medicine

Wrist FAQ

Question:

I saw a hand surgeon yesterday about getting a wrist replacement for my very bad, very painful wrist. She recommended a wrist replacement. I've had rheumatoid arthritis for so long, I don't know if I would know how to use it if she did fix it. She did make a comment I wondered about. She said I would have to to follow her directions exactly to get the best result. It didn't exactly sound like "my way or the highway" but I did wonder what she meant. Should I look for a different surgeon?

Answer:

The wrist with its double layer of bones and ability to turn and twist in all directions is a challenge to replace. For many years, anyone with severe wrist pain, deformity, loss of motion, and loss of hand function were offered only one treatment option: arthrodesis (fusion). But today, thanks to modern technology and improved surgical techniques, a total wrist replacement is possible. As more and more studies are done involving wrist replacements, surgeons are getting a better idea of what works best.a Any age can be accepted. They must have good enough bone stock to support the implant. And patient compliance (doing what the surgeon tells you to do) is very important. For example, usually after surgery, there is to be no carrying or lifting of anything heavier than 15 pounds for at least six weeks. After that there may be some other restrictions on heavy work like no lifting or moving heavy objects, gardening, or bowling. Doing too much too soon can compromise the surgery. The joint implant might come loose or even break. Just one wrong move could really make a difference in a negative way. It takes time for the healing response to lay down new bone around the implant so that it remains firmly fitted and stable. Patients are usually warned to be prepared for a few "less than perfect" results. For example, the implant does not allow enough wrist extension to push up from a chair with that hand. The wrist may be improved, but the fingers remain the same and that might be with pain and deformi For the most part, the majority of patients who receive a total wrist replacement for rheumatoid arthritis are pleased with the results. Motion and function are improved such that patients rate their results as satisfactory or completely satisfactory. Patients report it is possible to get used to doing things without full wrist motion but much better to have a wrist replacement that allows motion and function once again. They say the happiness of being able to fasten buttons, pick up loose change, and even walk the dog can't be measured! Angel Ferreres, MD, PhD, et al. Universal Total Wrist Arthroplasty: Midterm Follow-Up Study. In The Journal of Hand Surgery. June 2011. Vol. 36A. No. 6. Pp. 967-973.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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