Hello, I’m looking for anyone with a wrist fusion

Applemouse

I’ve had PA for about 15 years and it is generally fairly well controlled these days but, due to less good control in the past (or possibly some other reason), I now have severe osteoarthritis in my right wrist and I’m right handed so this does cause me serious problems with loss of function and pain. I’ve been offered a wrist fusion, but am unsure whether to go ahead with that now or try and put it off. It would be really helpful to talk with someone who has had this done and to learn about their experience.

There is also a possibility that I could have a wrist replacement (privately) but the surgeon is not too hopeful about a good result, and if I had that done when it fails, which it will at some point, a fusion would then be harder, so I’d also like to hear from anyone who has had a wrist replacement.

Thanks in advance

[Deleted User]

Hi Applemouse and welcome to the forum.
It sounds like a really difficult decision you are facing and everyone's individual health circumstances are so unique that it's so difficult to predict what will prove to be the best choice in the long run. I don't have direct experience of wrist surgery but hopefully there will be forum members who can share their experiences of wrist fusion or wrist joint replacement which may help you in your decision-making.
In the meantime, there's some information about wrist fusion and wrist joint replacement, the pros and cons and the recovery here:

https://www.versusarthritis.org/about-arthritis/treatments/surgery/hand-and-wrist-surgery/

When trying to make such decisions the BRAIN acronym can be helpful as a way of laying all the options out:
What are the
Benefits
Risks
Alternatives
What is your
Intuition
What would happen if you do
Nothing

Good luck and best wishes,

Ann

frogmorton

Hi

I know wrist surgery isn't the most common sort of operation people have on here, but I very much remember this lady's procedure.

She made a remarkable recovery!

https://arthritiscareforum.org.uk/viewtopic.php?f=8&t=16896&hilit=dorcas

If you go ahead it would be great if you posted a bit for future people who may be considering the same....

Hope it helps and best of luck.

Toni xx

Applemouse

Thank you Ann & Toni, you’ve both been most helpful. Does anyone know how Dorcas is doing now, coming on 10 years post wrist replacement? Is she still on the forum?

stickywicket

Hi and welcome from me too. I had a quick search and 'dorcas' last posted in 2015 which is a bit disconcerting as she used to be a very kind and helpful regular.

Mod Ann's link looks very useful. I know wrist replacements are very few and far between. Not surprising as the wrist is a very complex joint. Mine both fused themselves many years ago (RA>OA). I honestly can't remember how a normal wrist works but mine are no trouble at all now. Painfree. Straight, thanks to former use of splints and also good luck Useful. They were none of these before.

If I can help at all please just ask.

Applemouse

Thank you for that. Luckily my left wrist is really good still and I am learning to do lots of things left handed. The surgeon I saw in Southampton (I’m in Coventry) about possible wrist replacement said that people who still have one good wrist adapt well to having one fused, so I am taking heart from that. Having two fused must be more problematic - my husband has two fused ankles and that’s bad enough (he can only walk up steep slopes backwards ).

Any more experiences to add to the knowledge bank?

Thank you in advance.

stickywicket

Applemouse wrote:

- my husband has two fused ankles and that’s bad enough (he can only walk up steep slopes backwards :

That just goes to show how different we all are. My ankles have also fused themselves and I'm just the opposite. Going up steep slopes is no problem. Going down, unless I have a rail or very stable person to hang on to, I just gather speed :shock:

frogmorton

Applemouse wrote:

Thank you Ann & Toni, you’ve both been most helpful. Does anyone know how Dorcas is doing now, coming on 10 years post wrist replacement? Is she still on the forum?

Applemouse

I am still vaguely in touch with Dorcas as far as I know she is doing well - no regrets. I could ask her if she would pop by this thread maybe?

Toni xx

Applemouse

Toni

That would be great, as I’d love to know how it’s going for her after nearly ten years.

Thanks, Diana

frogmorton

Dorcas will get back to you tomorrow Applemouse. She was away when I contacted her and has plenty to tell you - all good too!

Love

Toni xx

Applemouse

Thank you so much Toni xx

dorcas

Hello Applemouse! Lovely to meet you ...and to reconnect with the Forum. It has been a long time indeed since I was last here.

I've had 6 Total Joint Replacements now, such has been the advance of ather ...both knees, right hip, right elbow, left p.i.p joint index finger... and of course the right wrist. The left wrist I had fused I think in 2010 and the total wrist replacement a couple of years or so later.

I have not regretted for one minute having these surgeries. They have given me my life back.

I'm right hand dominant and was faced with the same options and decision about whether to have the right wrist fused or go with a wrist replacement. The left wrist was not suitable for replacement due to the damage to that joint.
As you'll know, wrist replacements were and are still in the development stages compared to other replacements and not often recommended. My surgeon at the time though felt that I was a good candidate for wrist replacement and that hopefully it would result in some function being retained.

I was advised that there could be no guarantee of success..or of 'life-span' of the new wrist, which could be anywhere from as little as 1 year to ten years. Similarly that if the TWR failed, was damaged or eventually was worn out, that I'd then be offered a wrist fusion. Happily the replacement is still going strong and I've not had to be seen by the hand ortho for several years.

The Wrist Replacement was painful surgery, yes, and the physio difficult, but it has been worth doing! The additional movement and reduction in pain it has given me is so worth it ....and if asked I'd opt for the same again.

A word of warning though...it did not result in a fully functioning wrist so I don't want to mislead you! But the movement that I do have is significant and allows me to do much more than the fused wrist. A Wrist Replacement is fragile though so i do have to remember to protect it and not damage it through misuse! So far so good.

I did have to have further surgery to the left Wrist Fusion as I developed issues/ pain with the Distal Ulna head displacing but that was effectively dealt with in an op to remove the ulna head via..Darroch's Procedure. That wrist has remained pain free since and is very strong indeed. Movement of course is very limited. I have rotation (can turn the hand over palm down and back again) but no flexion ( no downwards or upwards movement) but to be honest you soon adjust to what you can and can't do.
And
Before the surgeries I was in severe pain and the joints were damaged and the limitations and effects debilitating, so it was a no brainer for me to have the surgery and I am so much better off for having had both (all) ops.

There's lots more I could say but it's probably best I don't waffle on! but please, ask any questions and if I can help I will.... t4591

[Deleted User]

Hello Dorcus

Lovely to see you on the forum Dorcus, it's been a long time, hope you are keeping well as best you can. Although it is sad news that has brought you here today, it is really pleasing to see you, you were always a favourite with the forum members (and the moderators), please call in again to see us again some time. Have a lovely Christmas, wishing you all the best for the New Year.

John

frogmorton

Thank you so much for calling by Dorcas really kind of you to help Applemouse with so much information.

Love

Toni xx

Applemouse

Dear Dorcas

Thank you so much, that information is all useful for me in looking to make the decision about fusion of wrist replacement.

The surgeon I’ve seen privately said it was JUST possible still to do a replacement, as the damage to my right wrist is severe, so it sounds like yours was a better candidate for the replacement than mine.

Also his guess at it going wrong quite quickly is 30-40% - not odds I really fancy. Plus he will have to remove bone to do the replacement, which would then mean that when I need a fusion (inevitable at some point) they would have to take bone from my hip to do that. So taking the option of a replacement now will make a later fusion a much more major prospect.

I’m worried that if I have the replacement I’ll mess it up as I do a lot of gardening and would have to only do light stuff out there to be safe .... and I might get carried away! Do you find it at all difficult to protect your right wrist? What do you avoid doing with it?

As my left wrist is still good his feeling is that I would adapt well to having one fused, but it is of course my dominant hand, which means that I am already having to learn to do more and more left handed.

I’m really torn, some days I think the fusion is the better option and others I do want to try the replacement - it’s a difficult decision.

Diana

Charw

Hi all,

I’m in a similar position so the versus team pointed me to this thread.
I had my left wrist fused in 2015 & unfortunately because I’m so tiny they had to use a finger plate instead of a wrist plate and I obviously caused problems for the surgeon and his team!
My wrist has been amazing until around a year ago when I felt it “pop”. Since they I feel like it jars bone on bone.

Anyway I’m here again facing 1 if not 2 surgeries. I was in clinic last week with the same surgeon & his team. The first doctor I saw managed to make my wrist piano key at the ulna.
So I saw the surgeon who explained what my options are and the next step. I’m to have an ultrasound on the left and CT scan of the right. If the tendons in the left are damaged I’ll have an operation to repair that first to protect the ulna from moving. If not then that will wait.
Then the CT scan is to check bone size. Like I said I’m really tiny so the surgeon isn’t hopeful but wants to rule out the option of replacement as he’s worried about how I’ll cope if both are fused.

I have 2 young children, & my job is hands based. Of course I’m scared and worried after he told me I may even have trouble wiping after the toilet if both are fused but equally it’s likely this is my only option. The scans will be in the new year and the follow up with surgeon shortly after to make a decision.
I thought fusion of both was the easy option until he listed the problems and challenges I will face. Like life isn’t already hard enough.
I was hoping to find someone who had both wrists fused to talk to me about the challenges.

Char

dorcas

Hello Diana
I can certainly understand the dilemma you're in! It's very difficult when the decision is left to us/ you.. and you only have the stark statistics to go on.
My surgeon said the same about statistics on success, and regarding how long the replacement might last his answer resembled, 'how long is a piece of string' . Not helpful, but in this day and age of people suing for medical compensation, its understandable.
Yes, they do remove bone in both wrist fusions and replacements, and pack around the fusion/ replacement with healthy bone tissue from either the wrist itself, or from the top of the hip (forgotten the name) .
I suppose the question you and I had to ask ourselves was ' Is a fusion the best option for a dominant wrist? ' . From my experience the replacement, whilst not having a full range of movement, nevertheless has a very useful degree of flexion and extension which allows me to still write and manage more intricate tasks that the fusion wouldn't easily allow.
As far as protecting the wrist from damage, I'd say it's just applying common sense when planning to do anything 'out of the norm'. I wear a wrist splint if I think I could potentially put that wrist under too much stress. To be honest that's not very often and for everyday tasks it's not necessary at all!
Yes if I was gardening I would wear the splint.... and sensibly I avoid lifting anything too heavy with it. If I do put it under stress I soon know as the wrist aches a warning!
I know the replacement won't last forever but I'm fine with that and won't worry when it comes to having it 'swapped' for a fusion. The fact that they will have to take bone graft from my hip is just a fact that I'll have to deal with. I don't mean to sound blasé about it, but I am a 'half glass full' kind of person and that's seen me through quite a few situations and quite a number of operations.

The Wrist fusion is definitely a safe option and is a permanent solution, but whilst being very strong it is limited. Great for carrying or lifting things and pain free for sure after a very short time, but as there's absolutely no flexion or extension some tasks are made more difficult or impossible.

Either option has its merits Diana. Both require you to adapt to the limitations they bring, but the beauty of being human is that we are entirely adaptable! The plus in having a fusion is to be pain free within weeks whereas with the replacement you'll be almost pain free but it takes longer ( only after the physio...and as long as you don't overdo things).

I've maybe muddied the waters for you Diana...so sorry if that's so! I'm trying to be as honest about my experiences as I can, but of course it's all very subjective.
I know the clock is running as far as making the decision about having a replacement is concerned..it's a very small window of opportunity that you have, and not an easy decision by any means.

Please do feel free to ask any questions you have. I'm here to help if I can x

,..........,.....................................................................
I meant to ask...why would you have to go privately for a wrist replacement or have I misunderstood?

dorcas

moderator wrote:

Hello Dorcus

Lovely to see you on the forum Dorcus, it's been a long time, hope you are keeping well as best you can. Although it is sad news that has brought you here today, it is really pleasing to see you, you were always a favourite with the forum members (and the moderators), please call in again to see us again some time. Have a lovely Christmas, wishing you all the best for the New Year.

John

Thank you mod John! Lovely to reconnect and be made so welcome. Hard to believe it's been so long....the years slip by unnoticed. I'm well just now thank you. New meds working a treat.
My best regards to you and all in the mod team. Hope you've all been behaving behind the scenes ?

dorcas

frogmorton wrote:

Thank you so much for calling by Dorcas really kind of you to help Applemouse with so much information.

Love

Toni xx

Thank you lovely Toni I do hope I can help. X

Applemouse

Hi Dorcas (and others)
You aren’t muddying the waters at all, I’m finding your input really useful.
The reason I’d need to go private, or at least it seems that way, is that my NHS surgeon only offered me a fusion. When I asked about a replacement he said that:
a) my wrist was too far gone for that option, in particular because it’s dropped (my ulna head is very prominent), and
b) because of my psoriatic arthritis the won’t be strong enough.
I decided that I needed a second opinion, so did a load of research and decided that the surgeon down in Southampton seemed one of the best around for wrists, so went to get my second opinion from him. I have another appointment with the NHS surgeon in January so I can talk through the options again, but I don’t want anyone who isn’t comfortable in doing a replacement having a go. The one in Southampton is saying that it is right on the edge of possible so I need someone who does quite a few replacements and has the skills to achieve it, not just have a go because I push it.
I have to admit I’m flip flopping at the moment between the two options. I really can’t see the painkiller and splint option lasting me long, the pain is too much.
More thought required!
Thanks again
Diana

frogmorton

Just incase someone doesn't know this already there are toilets available which will 'wash and blow-dry'. We don't need to loose all our dignity.

Thanks Dorcas still really helpful as you always are t4591

I hope our two new 'wristies' will hang around so they can help future people facing similar decisions.

Love to you all and hello to charw!

Toni xx

remmingtonwildhunter

Hi applemouse ive had both wfists fused one in 95 one in 2003 im a gardener by trade still gardening best thing i had done...
They open the hand up plate across joint 6 screws and one long screw they take the top of the hip of for the fushion back slab plaster for two weeks with drain ball clips out plaster on fof 8-12 weeks job done...
I have troubl with gates thats all still go up the gym still scuba dive and ride my push bike even passed my dan grade in aikido about 10 years ago so i woul go for it...
Why have a painfull stiff joint when you could have a painless fused joint... t78020

Applemouse

Hi Remmingtonwildhunter

Thank you, it’s good to hear of a really positive result of fusion. I take it you’ve adapted well to the lack of movement in the wrist of your dominant hand in particular? Do you really just have trouble with gates and nothing else?

Thanks again
Diana