ae86andkp61 (Forum Supporter)
ae86andkp61 (Forum Supporter) Dork
8/31/23 1:23 a.m.

Anyone have experience with wrist fusion? Life after wrist fusion?

Long story short, I'm 46 and I recently suffered a bad wrist injury on my dominant hand. The orthopedic specialist is hesitant about positive outcomes from a repair surgery (complex impacted break with likely cartilage damage and possible bone death) and has brought up the need to consider salvage surgery options including possible fusion surgery.

It's my right wrist, and I'm right-handed, and motorcycle riding is one of the most important parts of my life.

It's early days yet (a few hours out of initial consult) but I'm leaning towards pursuing long-shot repair first, and fusion later if necessary. Doc isn't discounting it, but advises that that path could lead to months/years of pain, arthritis, PT,, multiple surgeries, bone necrosis, and still need fusion at the end of it.

Right-here, right-now me says, "I've got a massive pain tolerance and huge personal reserve for PT/recovery, so let's try." I'm not sure how a custom left-hand throttle or thumb throttle would work for me. I understand that fusion is a one-way street with minimal pain and good strength, but can require a year or so of really re-learning how to use your dominant limb, and impacts riding, wrenching, writing, knife-chopping, tooth-brushing, and everything in-between.

I'd love to hear any personal stories of success/regrets. TIA.

mtn
mtn MegaDork
8/31/23 6:00 a.m.

Reading your docs concerns about doing rhe repair, I would be asking for more information on the bone necrosis.

What are the long term implications of that? To your hand and overall health?

I can deal with pain and annoyance for the chance of having full or close to full use of my hand again, but bone death would give me pause, admittedly without any research on it. 
 

I would also get a second opinion.

NermalSnert (Forum Supporter)
NermalSnert (Forum Supporter) HalfDork
8/31/23 9:00 a.m.

Sounds like Kienböck's disease. I used my palm as a battering ram to adjust a header on a house we were building 30 or so years ago and broke the lunate bone. About a year later I had it X-rayed and the doc said pick your favorite position and we'll fuse it. Nah. It bothers me every now and then but I'm living with it fine. They gave me a brace to wear - PITA. Never used it.

gumby
gumby Dork
8/31/23 9:42 a.m.

In for other's experiences. I was recently diagnosed with DISI in both wrists; the chronic overuse variety, not from acute injury.

Completed 4wks of PT/OT and have a larger portfolio of pain management techniques than ever before, but am being told the ultimate solution is carpal fusion. As a chassis fab/weldor, I'm not cool with that.

Placemotorsports
Placemotorsports Dork
8/31/23 10:08 a.m.

Odd timing for this, my son just fractured his wrist yesterday at school.  

fullbeans
fullbeans New Reader
8/31/23 10:46 a.m.

Talk to more doctors.

I had a damaged ankle and the first doctor (highly regarded, recommended by a friend) immediately started talking about a salvage surgery, fusing bones. I talked to a few other surgeons and all of them thought they could repair it without fusing the bones.

6 years later, I'm glad I didn't go with the first surgeon. My ankle isn't perfect, but it's better than what it would have been.

At 46, you've still got about as many years ahead of you as behind you. A couple years of recovery and PT is probably not that big of a deal in the overall picture.

 

 

ae86andkp61 (Forum Supporter)
ae86andkp61 (Forum Supporter) Dork
8/31/23 9:18 p.m.

Surgery scheduled for Tuesday. The surgeon is willing to discuss attempting a repair. smiley Fingers crossed for a good result! A fusion may still be in my future depending on how the arthritis and pain go, but I'm relieved to think that I may get a little useful time out of the wrist first!

 

The concern about avascular necrosis is the broken lunate. The break can result in not enough blood flow to the broken part, which then dies (Kienböck's) and makes the area arthritic, and can increase wear on everything surrounding. Due to the fact that it is a tiny bone completely covered in cartilage with very few vessels supplying blood, there isn't much to do but hope it heals. 

Pete. (l33t FS)
Pete. (l33t FS) MegaDork
8/31/23 9:30 p.m.

Quasi related, a friend broke his dominant forearm and the two bones fused together.  He can hold a shifter but has to eat left handed.

It happened while he was young enough that it was just part of life.

ae86andkp61 (Forum Supporter)
ae86andkp61 (Forum Supporter) Dork
8/31/23 10:43 p.m.

In reply to Pete. (l33t FS) :

All the vehicles I own (four wheels and two) have manual transmissions, so I'm a bit hosed for getting around on my own if I don't have use of all limbs.

The good news is that I have both RHD and LHD cars, so once the right arm is healed enough to hold the steering wheel, I'm golden! smiley The bikes will present their own challenge and might need some customization, but there's lots of adaptive setups out there for inspiration.

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