Houston Methodist. Leading Medicine

Wrist FAQ

Question:

My husband is in the hospital for septic arthritis of the wrist. He has surgery this morning to irrigate the joint and clean out any debris that has accumulated in there. The hope is that he will recover quickly and come home without any complications. How likely is that and how soon might I expect them to release him? They were very closed-mouth at the hospital about answering either question.

Answer:

Discharge planning can be difficult with septic arthritis because of the many and varied complications that are possible. If all goes well and there is no evidence of pus within the first 24 to 48 hours, then the patient may get the thumbs up for a quick and speedy discharge to home. The method used in carrying out this type of surgery can make a difference, too. For example, surgeons usually treat septic arthritis of the larger joints (hip, shoulder, knee) with arthroscopic irrigation and débridement. Open incision surgery remains the standard for the wrist. Arthroscopic surgery allows the surgeon to make tiny incisions that don't endanger the ligaments or cartilage. There is less pain and no open, draining wound. On the other hand, an open incision gives the surgeon a full view of the wrist anatomy making it easier to avoid cutting blood vessels or damaging other tissues such as nerves. After surgery, if there is any sign of persistent infection (fever, pus, red streaks in the skin, swelling), then the procedure may have to be repeated (sometimes more than once). Intravenous antibiotics aimed at the specific bacterial microorganism will be required. Most often, the cause of the infection is staphylococcus aureus, otherwise known as a staph infection. The length of his hospital stay may be determined by the need for continued intravenous antibiotics. So you can see why the staff can't really give you a straight answer. It isn't that they are avoiding your question. It's more likely they simply don't know what will happen. Be patient and ask the team to keep the lines of communication open. Douglas M. Sammer, MD, and Alexander Y. Shin, MD. Comparison of Arthroscopic and Open Treatment of Septic Arthritis of the Wrist. In The Journal of Bone and Joint Surgery. June 2009. Vol. 91A. No. 6. Pp. 1387-1393

*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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