Wrist artrhoplasty as a procedure is still in infancy but is promising.
A painless stable wrist is the key to hand function. Without arthroplasy, other procedures make wrist stable only by compromising its motion.
Arthroplasty is indicated in severe arthritis of the wrist not amenable to nonoperative measures in patients who do not have heavy demands from the wrist in daily use.
A total wrist replacement is generally indicated when a wrist that has sustained a traumatic injury or has been affected by a severe degenerative disease such as arthritis is unresponsive to other treatments and no longer able to function properly.
The goal is to provide painless mobile wrist to maintain function in the wrist and hand.
Procedure of Wrist Arthroplasty
Any joint arthroplasty does the procedure of removing worn-out ends of the bones are and replacing them with an artificial joint. The wrist joint is approached by dorsal approach.
For putting the prosthesis, several different designs of implants are available.
Most of these joints have two components of implants, one for each side of the joint along with polyethelene [ a high quality plastic] as a spacer between the two metal components.
One componentis inserted into the radius bone of the forearm. The carpal component [one that goes towards carpus and hand ] is inserted into carpal bone through one long stem and one or two shorter stems.
Outcome of Wrist Arthroplasty
After several weeks of plaster immobilization, the patient is put on range of motion exercises.
With careful use, an average implant is expected to last 10 to 15 years but the life of implant is decreased with heavy use of wrist.
Wrist arthroplasty is not a good option for patients who work that puts heavy load on the wrist. such patients should go for wrist arthrodesis instead.
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