Wrist Fusion (Total Wrist Arthrodesis)

A wrist fusion procedure, also known as total wrist arthrodesis, is a solution for individuals suffering from severe wrist conditions. During arthrodesis, a joint is surgically immobilized by fusing two or more bones.

Doing this relieves pain caused by the deterioration of cartilage in the wrist. Wrist fusion is an effective last resort when all other wrist arthritis treatments fail. It offers relief and improved quality of life for those enduring constant discomfort.

What You Need To Know About Wrist Fusion

Learn What a Wrist Fusion Procedure Is

Wrist fusion is a surgical intervention where the wrist joint is immobilized by fusing the forearm's radius with the wrist's carpal bones. This procedure is recommended when other treatments for severe wrist conditions fail, and it addresses advanced wrist arthritis, post-fracture complications, or significant ligament injuries.

The wrist joint is one of the most complex joints in the body because it is comprised of many small bones that meet with the radius bone of the forearm. The eight small bones of the wrist, or carpal bones, and the end of the radius are lined with a soft, cushioning substance called articular cartilage. When articular cartilage degrades to the point where it's causing severe pain and discomfort, it can be removed between certain joints, like the wrist joint, allowing the carpal and forearm bones to join together.

The ultimate goal of wrist fusion is to alleviate pain, restore functionality, and increase grip strength. Wrist fusion procedures have a high success rate; one study concluded a successful fusion rate averaging 91%, and many patients report significant functional improvement after their procedure.

Understand Why a Wrist Fusion Surgery is Performed

Cartilage deterioration can be the result of a variety of factors. Severe blunt trauma to the wrist joint, osteoarthritis, or overuse (seen in athletes like golfers, tennis players, and gymnasts) can all cause cartilage loss in the wrist and could potentially lead to the need for wrist fusion.

Wrist fusion is also a recourse after unsuccessful wrist reconstructions or joint replacements. This surgery involves fusing the wrist bones to the forearm bone, forming a single solid bone, thereby eliminating the pain caused by bone-to-bone friction. It's a preferred option for patients seeking lasting relief from debilitating wrist conditions.

The Best Ways To Prepare for a Wrist Fusion Procedure

Preparing for a wrist fusion procedure involves several key steps. To start, you will need a comprehensive physical examination to ensure you're in optimal health for the procedure.

If you smoke, it is recommended that you stop smoking at least 4-6 weeks before your procedure and for at least 4 weeks after to enjoy a faster and smoother healing process. Patients with diabetes should do their best to stabilize their blood sugar levels to lower infection risk and improve wound healing.

Fasting is also required 6 hours before the procedure, so patients should avoid eating, drinking, or chewing gum. Everyone is subject to different preparation guidelines, so following your physician's instructions is essential.

What Happens During a Wrist Fusion Procedure?

Every patient's journey is different, but usually, a wrist fusion procedure involves these common steps:

  1. Anesthesia Administration: The surgery will most likely be performed under general anesthesia, which means the patient will be asleep during the procedure.

  2. Preparation and Incision: The physician will clean the wrist and hand with an antiseptic solution and make an incision on the back of the wrist to minimize damage to blood vessels and nerves.

  3. Accessing the Joint: Tendons and ligaments are moved aside for a clear view of the wrist joint.

  4. Removing Articular Cartilage: The surgeon removes the cartilage from the joints involved in the fusion.

  5. Bone Graft Placement: If a bone graft is necessary, a physician will often take bone from the hip or pelvis and position it where the cartilage was removed to help promote bone fusion.

  6. Securing with Metal Plate: A metal plate, extending from the radius to the metacarpal bone of the middle finger, is screwed in place to hold the bones aligned during fusion. This plate will stay in the patient's hand permanently unless complications arise.

  7. Closing the Incision: Finally, the incision is closed with sutures.

The whole procedure usually takes around 90 minutes, and in most cases, the patient can leave the hospital once the anesthesia has worn down and transportation is arranged for them.

Are There Risks Associated With Wrist Fusion?

Every major and minor procedure comes with risks and possible side effects. Your physician and nursing staff will take every precaution to eliminate and significantly reduce the potential adverse effects. However, you should always be aware of the potential complications of your procedure. The complications that can arise as a result of wrist fusion include:

  • Ongoing pain

  • Bone fusion failure or non-union

  • Infection

  • Complications with the plate or screws

  • Worsening of carpal tunnel syndrome

  • Nerve or blood vessel damage

  • Excessive bleeding

  • Tendon rupture

Post-Op & Wrist Fusion Recovery

Wrist fusion recovery involves patients carefully complying with post-surgical instructions from their physician to ensure a successful recovery. At the onset, patients should keep their arm elevated and immobilized in a cast for up to 6 weeks to facilitate bone fusion. This will be followed by gradual rehabilitation through physical therapy.

Physical therapy usually starts around 8 weeks post-surgery, and it will focus on restoring wrist function, strength, and range of motion. Full use of the wrist is typically allowed at about 10 weeks, with recovery and strength improvement extending up to 12 months. Patients need to avoid lifting heavy objects and follow all medical advice during this period for optimal recovery.

If you or someone you love suffers from chronic wrist pain and discomfort, schedule an appointment with us to consult with one of our outstanding physicians.

Find a Doctor

Virtual After-Hours Access

Resurgens Orthopaedics has partnered with the HURT! app to offer FREE virtual after-hours access to orthopedic specialists right when you need it.

Receive immediate guidance on your injury!