Total wrist fusion is predominantly performed for severe wrist arthritis. A total wrist fusion stops all movement at the wrist joint, so it is not an operation to undertake lightly. However, it provides welcome relief for patients who are unable to use their hand due to wrist pain and instability.
The severe arthritis that leads patients to a total wrist fusion can be the result of a number of conditions. Sometimes damage to the wrist ligaments as a young adult sets up changes in wrist biomechanics that lead to progressive arthritis. Sometimes rheumatoid arthritis is the underlying cause. There are also other uncommon reasons patients may undergo a wrist fusion – when part of the wrist has to be removed due to cancer or infection, or when there is paralysis of the wrist or hand.
What does total wrist fusion surgery involve?
The surgery involves having a metal plate will be placed across the wrist joints, preventing movement. The cartilage surfaces of the wrist bones will be removed, and bone graft placed between the gaps to facilitate bone-to-bone fusion. The bone that is used for grafting is generally taken from the bones around the wrist that is undergoing the fusion.
Total fusion wrist complications
Complications may include ongoing pain, non-union (failure of the bones to fuse), plate or screw fracture or loosening, worsening of carpal tunnel syndrome, an unsightly scar and rubbing of tendons on the plate leading to rupture of tendons.