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wrist fusion or wrist replacement ?
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wrist fusion or wrist replacement ?

I fell at work over 3 years ago. Fractured both wrists. Plates were put in ,plates were took out.Had the carpul tunnel thing done.Still in alot of pain.The bones are rubbing against each other. Fusion has been recomended for both. Trying to decide on fusion or wrist replacement.
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Avatar_f_tn
Hello Dear,
A fusion of any joint eliminates pain by making all the bones grow together into one solid bone. When the bone ends can no longer rub together, there is no more pain.
The goal of a wrist fusion is to get the radius in the forearm, the carpal bones of the wrist, and the metacarpals of the hand to fuse into one long bone. The ulna of the forearm is not included in the fusion. The joints between the ulna and the radius are what allows you to turn the palm of your hand up and down. By not fusing the ulna, you should still be able to rotate your hand. However, you will not be able to bend your wrist after the operation.
Arthritic conditions, such as rheumatoid arthritis or osteoarthritis, fractures, dislocations, or long-time instability of the wrist bones can destroy all or most of the cartilage that forms the smooth surface of the many wrist bones. When that happens, the wrist becomes painful and loses motion
When the pain and functional impairment keeps you from your daily activities, you may seek the advice of your physician. You may consider wrist replacement surgery. The surgery is complicated.
The decision of fusion or replacement will depend on your symptoms and pathology of the joint.Best can be decided by your surgeon.

Refer http://www.allaboutarthritis.com/AllAboutArthritis/layoutTemplates/html/en/contentdisplay/document/condition/arthritis/clinicalArticle/Wrist_Replacement_Surgery.htm
Best

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Avatar_f_tn
I have had just about everything done to my wrist you can imagine all the way up to a wrist fusion.
My problem now is I have ulnar impingement with DRUJ instability with DJD. Plus they tell me I have curvature of the ulnar shaft.
I can not do anything with my wrist/hand as of now.
My doctor suggested hemi recetion with ulnar shortening but he wanted me to get a second opinion. So I did and the doctor says if I have the shortening with recetion I am still going to have pain, soft tissue could be contracted(shortened) and I may have no more movement (palm up, palm down)
Plus other procedures he did not think would have good outcomes where sauve kapandji or limited darrach resection. I am so lost. When I asked this new doctor if he could do the procedure he told me no, that it was too complicated.
I haven't gone back to original doctor yet. Going to get one more opinion.

I was curious though. I don't need to do the heavy lifting. Mostly all I need is the movement. I am young and I know they frown on wrist replacements in young people only cause they only last 10-15 years which means I would need at least 2 of them. But what also is considered in a wrist fusion? My original injury I tore all the ligaments in my hand. All my tendons are good. Because of tearing all the ligaments the sl, lt and tfcc is a wrist replacement out of the question? I am really lost and dont know what to do. Thank you for your time
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