It's always hard to think of a fusion as a way of improving function, but it seems to be a good outcome for people with severe wrist arthritis.
What is a fusion? A fusion is a term used when a joint (which moves) is stiffened. This is basically achieved by removing all the cartilage and leaving the bare bones which stick to each other. At the wrist, this can help with pain, as a painful wrist has very limited movement, anyway. The shoulder and elbow have to do more work, but they can cope. The wrist is fused with a plate (a thin piece of metal which reaches from the back of the hand to the forearm bone (radius)), which is then screwed into place. The bone itself then has to knit, which takes a variable amount of time. This is significantly slower if you smoke. Most patients like a fibreglass cast for 6 weeks, and then may use a splint for another 6 weeks. At this point, there is better movement of the fingers, and the arm becomes more functional. If the plate is uncomfortable, it can be removed at a later date.
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AuthorOrthopaedic Surgeon in Cairns, Far North Queensland Archives
September 2016
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