by Nancy Callinan, MA, OTR, CHT
The ulna, the long forearm bone that joins the wrist at the little finger side of the hand, has a knob-like bony prominence on its wrist end. Sometimes, this knob becomes enlarged, causing pain when the tendons glide over it. Sometimes, the tendons may even rupture or tear, worn down by the constant friction. Excision surgery is used to correct it. During surgery, the surgeon smooths the enlarged bone and covers the area with a layer of soft tissue taken from the joint capsule or a ligament so that the tendon won’t wear down.
When the wrist is unstable or painful, arthrodesis helps to stabilize it. Arthrodesis is an effective alternative to arthroplasty at the wrist, but it does result in loss of wrist motion. How much wrist motion is lost depends on how many bones need to be fused. Usually, two of the small wrist (carpal) bones are fused to the radius, the long bone of the forearm that attaches to the thumb side of the hand. If you have this surgery, your surgeon may use bone taken from another part of your body to help promote healing and new bone growth so that the carpals will fuse. After surgery, your wrist will be immobilized in a splint or cast for up to 10 weeks. You may retain 25% to 50% of normal wrist motion following arthrodesis.
You may feel pain after your surgery. Be sure to take any pain medicine recommended by your physician. Sometimes, after-surgery swelling can contribute to pain, but you can minimize swelling by propping your hand up above your heart whenever possible for the first two days. You can also use a cold pack to reduce swelling and pain. If swelling persists, your surgeon may recommend a compressive wrap or glove. It is important to keep the surgical incision clean and dry, so you may need to put a plastic bag over your hand for showering and bathing. Follow the recommendations of your surgeon or therapist regarding moving your hand after surgery.
You depend on your hands every day for numerous tasks, so the restrictions in hand use that occur after surgery can significantly affect your independence. If you are planning to have hand or wrist surgery, here are a few things you can do ahead of time to make life easier when you can only use one hand:
With careful planning, a qualified surgeon, and attention to proper after-surgery care and therapy, you could be on the way to some wonderful changes in your life.
Last Reviewed on September 15, 2010
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