Wrist & Hand Surgery

Warning Signs you may need for Wrist or Hand Surgery

Wrist and hands are very unique in terms of their function as well as their anatomy. They have a complex series of bones, joints, tendons, pulleys, nerves and blood vessels that can be affected by a great number of conditions, all of which may cause the patient abnormal symptoms such as stiffness, pain, or difficulty performing certain tasks such as occupational tasks like using a screwdriver or work duties that require high levels of manual dexterity or wrist strength.

Symptoms may include stiffness in the wrist or any of the digits, inability to perform full range of motion within any of the joints of the wrist or the hand, pain at rest or that is provoked with certain movements of the hand or wrist and significant deformities that may be in or around the wrist joint or anywhere on the hand.

If you have any concerning symptoms that you think may be related to a hand or wrist condition that might require surgery, consultation with one of our orthopedic surgeons including a full and complete history and physical examination as well as possible imaging studies including plain film radiographs and cross sectional imaging will ensure that we can make a firm diagnosis and discuss your management options with you.

Who is a good candidate for Wrist and Hand Surgery?

Any patients who experience any of the aforementioned symptoms and find these symptoms interfere significantly with either their work or personal daily life would potentially be a candidate for surgery.

Given the complex nature of hand and wrist anatomy, the cause of the patient’s symptoms may be such that there are no good surgical options to address their problem. However, it may equally be as a result of a condition that is very easily successfully fixed with surgery. It is not always obvious to the patient and, indeed, the clinician which is the culprit and as such a prompt and thorough consultation with a specialist orthopedic surgeon is always warranted so that a full and frank discussion about the patient’s management options can be had as soon as possible.

Wrist Surgery Procedure

Although there are a great number of different procedures that can be performed for the patients who have wrist symptoms, each one is very different and will be very specific to the underlying issue. For example, a patient with ulnocarpal impaction may require an ulnar shortening osteotomy to relieve that pain, but this procedure is very different both conceptually and in its execution than, for example, a procedure for wrist arthritis which may include arthroplasty, proximal row carpectomy or even wrist fusion.

There are also some conditions that are amenable to treatment with wrist arthroscopy. This involves placing a small camera into the wrist joint itself and performing an arthroscopic assessment of the joint, making a diagnosis based on the findings during arthroscopy and potentially addressing the issue with arthroscopic surgery.

To know whether there is a wrist procedure that is suitable for your wrist complaint, consultation with one of our specialist orthopedic surgeons is essential.

Hand Surgery Procedure

Hand anatomy is arguably even more complex than wrist anatomy and, as such, there are myriad of different hand conditions that may cause troublesome symptoms. The treatments for these can range from nonsurgical interventions such as injections and hand therapy to the surgical procedures such as fusions, osteotomies, excisions and, in more severe cases, amputations.

Some of the more common conditions that we see in the hand that benefit from surgical intervention include Dupuytren’s contracture, first digit carpometacarpal arthritis and malunion from previous fracture or injuries.

If you think you may be suffering from any of these and wish to discuss whether there is an effective surgical procedure for your condition, consultation with one of our specialist orthopedic surgeons will give you the information you require be able to make an informed decision as to whether you wish to proceed with surgery as a treatment option.

Wrist and Hand Surgery Succees Rate

Although there are a number of conditions in and around the hand and wrist that are very amenable to surgery and have a very good success rate including wrist fusion, wrist arthroscopy and ulnar shortening osteotomy, there are also a number of conditions in the hand and wrist where the surgical success rate is much lower due to these conditions being more difficult to deal with (e.g. Kienbock’s disease, proximal pole scaphoid nonunion and various posttraumatic conditions of the hand).

Given the diverse array of surgical procedures available to treat the various complaints in and around the hand and wrist, is impossible to apply a single figure to describe the success rates of all hand and wrist procedures. It is much more accurate to discuss the specific surgical procedures relevant to each patient, and to cover the success rate of each procedure during the discussion tailored to each patients needs.

If there are surgical options for your condition and our surgeons feel that you have a high chance of success with these procedures, we will stress this to you during your consultation and advise you as to whether you would be best served following nonsurgical management pathways instead.

Recovery and Timeframe

As with any arthroscopic procedure, wrist arthroscopy recovery is very quick and usually within two weeks the patient is fully recovered from this procedure.

Any procedure that involves osteotomy or any fusion procedure requires a longer amount of time for the osteotomy to heal or the fusion to consolidate – this usually takes longer; between 6 and 12 weeks.

Other procedures that involve different types of surgery may take even longer for the patient to fully recover due to the nature of the procedure itself. In depth discussion of these in detail should be had with your surgeon at the time of you consultation, as these are much rarer.

Management of expectations is important in hand and wrist surgery particularly if the patient performs duties as part of their occupation that require a great deal of hand and wrist dexterity. For example, if a patient performs a job involving a great deal of manual labor that relies heavily on hand and wrist movements such as use of the screwdriver or similar and they have to undergo a wrist fusion, it is important to counsel them that they will lose a great deal of range of motion in the wrist and this may very well affect their ability to perform these repetitive and challenging tasks when their fusion has fully taken.

As such, the recovery plans for each patient will be different and tailored to your specific context, occupation and lifestyle and your surgeon will be able to advise you on this better on an individual basis.

Conclusion

With complex and unique anatomy, surgical procedures of the hand and wrist vary widely in terms of their basic principles, technique and their goals of treatment. As such, there are a wide number of conditions in the hand and wrist that can be addressed with surgery with varying degrees of success. If you are concerned that you have a hand or wrist complaint and wish to know more about any surgical procedure that you may be a candidate for then contact our office and arrange a consultation with one of our specialist orthopedic surgeons who will be happy to discuss your condition with you, as well as all of the potential treatment options for you.