The traditional treatment for arthritis in the wrist is a fusion. In this procedure the arthritic joint is permanently stiffened up with a metal plate and screws. This is a very good pain relieving procedure and is probably the procedure of choice for most patients. You will lose any remaining up and down or side to side movement of the wrist. It will not affect your ability to turn the hand palm up or down. For this operation it is particularly important that you do not smoke in the period around your surgery as it significantly increases the chances of the bones not joining.
The operation itself takes around an hour and a half to two hours and can be done under general anaesthesia – with you asleep; or under regional anaesthesia – with a numb arm. There will be a scar on the back of the hand, typically around 20cm. This can be quite a painful procedure and most people need one or two nights in hospital.
After the operation you will be given exercises to get the fingers and thumb moving immediately and will be in a cast for six weeks. After the first two weeks you will come back to have your stitches taken out and be put into a new cast. It typically takes 6-12 weeks for the joint to fuse and you will need to avoid heavy activities for this period. The metal plate should stay in for life but can be removed if it is causing problems.
Any surgery carries risk; in addition to the risks of any surgery to the hand; the main risk with a wrist fusion is non-union – this is when the joint fails to fuse and requires further surgery.