Arthritis of the wrist
Bones articulate through joints that are covered with a layer of cartilage. When the cartilage wears out, arthritis develops. Inflammation and bare bone rubbing against bare bone will cause pain
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What causes arthritis of the wrist?
- Trauma: Intra-articular fractures will also damage the cartilage lining of the joints.
- Wear and tear arthritis due to aging process.
- Rheumatoid arthritis and other types of inflammatory arthritis.
What are the symptoms?
- Deformity and swelling.
- Pain with motion.
- Stiffness.
How to diagnose it?
Clinical examination will show:
- Tenderness around the joint
- Deformity or angulation
- Limited range of motion
Tests:
- X-ray of the involved joint will show various degrees of joint destruction
- Blood tests
Functional treatment
NSAIDs, corticosteroids; drugs and splinting are the mainstay of conservative therapy.
Surgery
Joint fusion or replacement can be considered depending on the affected joint and lifestyle.
Several selective joint fusions can alleviate pain while preserving motion.
Different types of partial wrist fusions include
- Four corner fusion with resection of the scaphoid.
- STT fusion (between scaphoid, trapezium and trapezoid)
- Capito-lunate fusion (between capitate and lunate)
- Scaph-capitate fusion (between scaphoid and capitate)
- Radio-scapho-lunate fusion (between radius, scaphoid and lunate)
We will always favour motion-preserving procedures but in very advanced stages, only a formal wrist fusion will treat the pain.
Wrist arthroplasties include proximal row carpectomy, partial joint resections (such as distal scaphoid resection to treat STT arthritis).
Arthroscopic procedures are evolving significantly and new implants are being developed to improve the possibilities of minimally invasive wrist surgery.
Theses sophisticated surgical procedures require period of postoperative immobilization, to allow bones and joints to heal.
Possible complications include pain, bone non-union, stiffness, nerve or tendon injuries and the need for additional procedures, such as :
- Capitolunate fusion
- Four corner fusion
- Partial wrist fusion
- Total wrist fusion
Relieve your pain quickly
Relieve your pain quickly
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Practical medical guides
Dr. Brutus offers a series of publications on a variety of health topics. Written in a clear and simple language, in collaboration with experts of various fields, these books are offered free of charge in downloadable version.
By Jean Paul Brutus MD and Nathalie Brisebois
Practical medical guides
Dr. Brutus offers a series of publications on a variety of health topics. Written in a clear and simple language, in collaboration with experts of various fields, these books are offered free of charge in downloadable version.
By Jean Paul Brutus MD and Nathalie Brisebois