Wrist Surgery at Middlesex Hospital
It’s easy to injure your wrist, typically by falling, repetitive motions or through sports and work injuries. Sprains are common, as well as fractures, tears or nerve injuries. A sprain is an injury to a ligament, which is a strong band of connective tissue that connects one bone to another. There are many ligaments in the wrist that can be stretched or torn, resulting in a sprain. This occurs when the wrist is bent forcefully, such as in a fall onto an outstretched hand.
Additionally, arthritis afflicts millions of Americans. Arthritis is inflammation of one or more of your joints. A joint is where the ends of bones meet -- inflammation causes swelling, pain, and stiffness in the joint.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition in which there is pressure on the median nerve - the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.
The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow, so any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome.
Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel.
It is important in all but very mild cases to have a physician evaluate wrist pain. Proper diagnosis and treatment is necessary to avoid long-lasting stiffness and pain.
Dealing with arthritis and joint pain
Many people have arthritis in their wrists and hands, making daily activities difficult. Although there are hundreds of kinds of arthritis, most wrist pain is caused by just two types: Osteoarthritis and rheumatoid arthritis.
Osteoarthritis (OA) is a progressive condition that destroys the smooth articular cartilage covering the ends of bones. Healthy joints move easily because of articular cartilage. When the bare bones rub against each other, it results in pain, stiffness, and weakness.
Osteoarthritis can develop due to normal "wear-and-tear" in the wrist, particularly in people who have a family history of arthritis. It may also develop as a result of a traumatic injury, such as a broken wrist bone or a wrist sprain. OA of the wrist joint causes swelling, pain, limited motion, and weakness. These symptoms are usually limited to the wrist joint itself.
Rheumatoid arthritis (RA) is a chronic disease that attacks multiple joints throughout the body. RA often starts in smaller joints, like those found in the hand and wrist. It is symmetrical, usually affecting the same joint on both sides of the body.
In general, early treatment is non-surgical and designed to help relieve pain and swelling. Several therapies can be used to treat arthritis, including:
- Modifying your activities. Limit or stop the activities that make the pain worse.
- Immobilization. Keep the wrist still and protected for a short time in a splint to help relieve symptoms.
- Medication. Take non-steroidal anti-inflammatory medications, such as aspirin or ibuprofen, to reduce pain and swelling.
- Exercise. Follow a prescribed exercise program. Specific exercises can improve the range of motion in your wrist.
- Steroid injection. Cortisone is a powerful anti-inflammatory medicine that can be injected into the wrist joint.
Surgical treatment at Middlesex Hospital
When non-surgical treatments are no longer effective, resulting in progressive loss of hand and wrist function, surgery is an option. The goal of surgery is to relieve pain and to preserve or improve hand function.
Surgical options include:
- Removing the arthritic bones. In this procedure, three small (carpal) bones are removed. This procedure will relieve pain while maintaining partial wrist motion.
- Fusion. When motion is the source of pain, carpal bones can be fused together to make one, solid bone. A fusion can be partial, in which just some of the carpal bones are fused together. This eliminates pain and retains some wrist motion. When the arthritis is extensive, a complete fusion may be necessary. In this procedure, all of the carpal bones are fused together, as well as the radius. This completely eliminates wrist motion, but does not affect forearm rotation.
At Middlesex Hospital, our orthopedic surgery department specializes in a variety of diagnostic procedures designed to carefully analyze your wrist injury or condition and determine the best course of action. We then help you navigate surgical and non-surgical recommendations and follow-up requirements. If your wrist requires surgery, our Board-certified surgeons and highly experienced orthopedic surgical team perform a variety of advanced surgeries, using the most sophisticated tools, customized materials and technologies.