What is the wrist joint?

In human anatomy, the wrist is variously defined as:

  • The carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand,
  • The wrist joint or radiocarpal joint, the joint between the radius and the carpus
  • The anatomical region surrounding the carpus including the distal parts of the bones of the forearm and the proximal parts of the metacarpus or five metacarpal bones and the series of joints between these bones, thus referred to as wrist joints. This region also includes the carpal tunnel, the anatomical snuff box, the flexor retinaculum, and the extensor retinaculum.

The wrist joint is also a synovial joint, meaning that it contains a fluidic capsule that sits between two bones that move against each other (in this case, the wrist bones and the forearm bones). The synovial capsule lubricates the joint, allowing for smooth movement.

The tendons that control the articulation of the wrist run through the forearm. The tendons that help move the wrist include the flexor carpi radialis, flexor carpi ulnaris, palmaris longus tendon, extensor carpi radialis brevis, extensor carpi radialis longus, and extensor carpi ulnaris.

Common Wrist Conditions And Injuries

Because the wrist is used so frequently to perform different tasks, mild to severe wrist injuries can be quite common. Injuries can be caused by overuse and sudden trauma (normally the result of a fall on an outstretched arm or lifting a weight that is too heavy).

Common wrist conditions and injuries include:

  • Wrist tendinitis – Inflammation and irritation of the tendons that control the wrist joint.
  • Carpal tunnel syndrome – A pinched nerve in the wrist that causes pain, numbness, and tingling.
  • Wrist arthritis – Disease that destroys the cartilage around wrist bones, causing them to rub together and cause pain.
  • Wrist fractures – Sudden trauma to the wrist bones that cause them to break, either partially or completely.
  • De Quervain’s tenosynovitis – When tendons surrounding the base of the thumb become irritated or inflamed, causing pain on the thumb side of the wrist that gets worse with activity.
  • Ganglion cysts – Fluid-filled lumps that develop in the wrist or hand. They develop due to fluid leakage from a tendon and are mostly benign but require treatment if they cause pain and discomfort.
  • Sprains and strains – When ligaments supporting the wrist are stretched beyond their limits or forcefully twisted, becoming partially or totally torn (ruptured).

How Can A Wrist Injury Be Diagnosed?

Diagnosis of wrist injuries and conditions starts with a physical examination by a doctor. The doctor will check for swelling, tenderness, and deformity. They will also test grip strength and the flexibility of the wrist joint.

If required, your doctor may advise you to undergo a form of diagnostic imaging. Imaging procedures used to diagnose wrist injuries and conditions include:

  • X-rays
  • CT Scans
  • MRI scans
  • Ultrasound
  • Electromyography
  • Wrist arthroscopy

Your orthopaedic surgeon at Melbourne Arm Clinic can perform a wrist arthroscopy to help diagnose and repair problems inside the wrist joint.

What Are The Treatment Options For Wrist Injury?

There are various surgical and non-surgical treatments to address wrist injuries and conditions. The correct treatment depends on the nature and severity of the problem.

Relatively minor wrist injuries can be treated with a combination of rest, immobilisation with a cast or bandage, and medications. Severe wrist injuries and conditions like advanced carpal tunnel syndrome, wrist arthritis, or wrist fractures often require a form of surgery to provide long-term relief to patients.

Types of Wrist Surgery

Total Wrist Fusion Surgery

Total wrist fusion surgery, also known as total wrist arthrodesis, involves the small bones of the wrist being fused with the forearm bone to stabilise or immobilise the joint. This procedure stops all movement at the wrist joint and is typically performed to treat severe arthritis or if part of the wrist has been removed due to infection or cancer.

Wrist Arthroscopy

Wrist arthroscopy involves one or several small incisions near the wrist joint to allow a tiny camera inside. With this camera broadcasting to a screen, the surgeon can investigate and repair issues within the wrist joint using miniature tools.

Wrist Arthritis Surgery

Depending on the severity of the condition, arthritis in the wrist can be treated in several ways. Common procedures to treat wrist arthritis include wrist fusion surgery, wrist replacement, and a carpectomy (removal of small bones of the wrist joint).

Wrist Replacement Surgery

Wrist replacement surgery, also known as wrist arthroplasty, is when the damaged or diseased part of the wrist joint is replaced with a prosthetic. Wrist replacement surgery is often undertaken in conjunction with other procedures with the goal of correcting disorders and deformities in the fingers and thumb.

Partial Wrist Fusion

A partial wrist fusion is like a total wrist fusion, except that it allows for some wrist movement to be retained. There are several types of partial wrist fusion procedures, including radioulnate, scaphocapitate, and STT fusion, among others.

Wrist Surgery: FAQs

How long does wrist surgery take?

Depending on the type of surgery and the severity of the issue being addressed, wrist surgery can last between 30 minutes to several hours. For a severe injury like a wrist fracture, you may also need to spend one or two nights in hospital after your surgery.

How much does wrist surgery cost?

The cost of wrist surgery will depend on what surgery you are getting and your level of private health insurance. Medically necessary procedures will be covered by Medicare, reducing out-of-pocket costs.

What are the complications of wrist surgery?

Apart from complications inherent to any type of surgery (negative reaction to anaesthesia and infection), possible wrist surgery complications include nerve damage, reduction in wrist strength and flexibility, and blood vessel injury.

Matthan Mammen
ELBOW, WRIST AND HAND SPECIALIST

Mr. Matthan Mammen

MS, FRACS (Orth)

Matthan is an internationally qualified orthopaedic surgeon, who is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

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