As a wrist surgeon I can tell you that wrist injuries are very common. If you think about how much we use them on a daily basis this should come as no surprise, after all they are subject to wear and tear. Many wrist conditions and injuries heal themselves over time, but some will need treating.
Now, let’s take a look at some of the most common types of wrist conditions and injuries we see:
Common Wrist Conditions
#1 Wrist Arthritis
There are two main types of wrist arthritis: rheumatoid and osteoarthritis. Osteoarthritis is usually diagnosed as being either primary (occurring for no obvious reason) or secondary (occurring due to an underlying cause). The most common cause for secondary arthritis is a ligament injury or a previous injury (such as a fracture) in the joint.
Treatment for wrist arthritis usually starts with non-surgery options such as activity modification, pain killers and/or a wrist splint for certain activities. If surgery is needed then there are several options available such as a wrist fusion (arthrodesis), wrist arthroscopy or a wrist denervation, but Mr Murray will be able to recommend the best hand treatment for you once he has examined you more closely.
#2 Wrist Ganglion
A ganglion is a fluid filled cyst that is usually found around a tendon or join and so is quite common in the wrist area. There are found main types of wrist ganglion: dorsal, mucous, pulley or ‘seed’ and volar. Ganglia tend to be painless, although you may experience discomfort from the underlying problem joint or tendon.
Ganglions usually resolve themselves over time, but many people want to speed this process up as they can look unsightly. One option is to have the ganglion drained under local anaesthetic using a needle (known as aspiration). Aspiration has a success rate of about 50% and can be repeated if needed. If aspiration is unsuccessful or the ganglion returns then surgery may be considered – and the surgery required will depend on the type of ganglion you have.
Common Wrist Injuries
#1 Wrist Ligament Injury
The wrist contains many ligaments, and these ligaments tend to start failing through wear and tear once you have reached the age of 40 plus. Ligaments may also tear due to falls but you may not feel the symptoms for years.
As with wrist arthritis treatment for wrist ligament injuries will usually start with non-invasive options such as pain killers, activity modification or a wrist splint. If these don’t work or Mr Murray feels that surgery would be better, then there are a few options: partial wrist fusion/excision, wrist arthroscopy and washout and wrist denervation.
#2 TFCC Injury
TFCC is the soft tissue structure which connects the radius and ulna bones around the wrist. The TFCC is quite susceptible to tearing, and many people who present to Mr Murray with pain at the wrist or weakness of grip tend to be suffering from a TFCC injury.
Initial treatment for TFCC injuries tends to be non-invasive and usually consists of the patient wearing a cast or splint for a period of time alongside anti-inflammatories to help pain management. However, if this fails then there are surgical options which tend to be arthroscopic and are completed using key hole surgery.
#3 Scaphoid Fracture
The scaphoid is one of the eight small bones which make up the ‘carpal’ bones of the wrist and fractures tend to occur in this area due to a fall onto the outstretched hand. Some scaphoid fractures can be treated in a plaster cast (if they are un-displaced). If the scaphoid fracture is displaced then you will probably need to be treated operatively.
Operative treatment for scaphoid fractures tends to be completed under general or regional anaesthetic. There are two main types of scaphoid fracture operation: ‘open’ surgery which is the more traditional type of surgery and ‘percutaneous fixation technique’ which is more modern. Overall healing rate for both open and percutaneous surgery is very similar, but rehabilitation is slightly quicker with percutaneous surgery due to the fact there is less soft tissue trauma.
If you are struggling with hand, shoulder or elbow pain Mr David Murray is a specialist in hand, wrist and elbow surgery and he would be more than happy to talk to you about your options. You can call him on 01204 416186 or email him at firstname.lastname@example.org