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Early- stage wrist arthritis can usually be managed with splinting, medication, and modification of activities. If these non-surgical treatments don’t work, wrist fusion has been the treatment of choice to alleviate pain and improve joint function. However, patients frequently report limitations after fusion involving everyday activities that benefit from motion, such as perineal care and button fastening.
Wrist replacement can be a choice for patients who are reluctant to have a wrist fusion. Wrist replacement is most commonly performed on patients with rheumatoid arthritis, but it is also used to treat post-traumatic arthritis and osteoarthritis. Wrist treatment is performed by using some orthopedic implants and instruments, provided by orthopedic instrument manufacturers.
Wrist joint replacement can be done as an outpatient procedure, unlike a knee or hip replacement. Wrist replacement surgery is usually combined with other procedures or correct disorders or deformities in the nerves, tendons, and small joints of the thumb, or fingers. Surgeons perform surgery with the help of medical tools.
The incision is made on the back of the wrist by Surgeon. The injured ends of the lower arm bones are removed, and the first row of carpal bones may also be removed. The radial section of the prosthesis is inserted into the center of the radius bone on the outside of the lower arm. It is held in position with bone cement.
Depending on the design of the component, the carpal component is then inserted into the center hand bone (third metacarpal) or screwed into the remaining row of carpal bones.
An approximately sized spacer is used between the metal components.
A cast will need to be worn for the first of numerous weeks. When the cast is removed, a protective splint will be required for the next 6 to 8 weeks. However, pain relief is immediate, gradual exercises will need to be done for many weeks to restore movement and, eventually, to increase endurance and power. Wrist arthroplasty can improve movements to about 50% of normal.
The physical demands that are placed on the wrist prosthesis will influence how long the orthopedic implants or (implantes ortopedicos)lasts. There will be some limitations. Use of pneumatic tools or hammer may need to be avoided. The amount of weight lifted will need to be limited. A fall on the outstretched hand may break the prosthesis, just as it might fracture a normal wrist, thus activities that could result in a fall, such as roller sports, should be avoided.
Although there have been important advances in wrist prosthesis, orthopedic implants may loosen or fail, because of wear or deformation. In these cases, additional surgery may be essential.
Approximately, a wrist replacement can be expected to last 10 to 15 years with careful use. As with all orthopedic implants, long-term follow up is advised. Usually, follow up every year or every 2 years will identify any developing conditions or problems.