Scaphoid Fractures

In a bone graft procedure, pieces of bone are taken from another portion of the patient’s body, usually the pelvic area, and are used to fill in the crack that has developed between the fragments of the broken scaphoid bone.

An alternative surgical procedure involves replacing the scaphoid bone with a titanium metal implant, which functions in effect as an artificial bone (see illustration at left).

Carpal Tunnel Syndrome

The surgical procedure for Carpal Tunnel Syndrome involves opening the volar carpal ligament (see illustration). Frequently, the portion of the lining around the nerves and tendons is also removed. This part of the procedure is called a synovectomy. The objective is to help reduce the pressure that occurs within the carpal canal and allow more room for the tendons and median nerve to course through this closed space.

DeQuervain’s Disease

The surgical procedure for DeQuervain’s Disease involves cutting the thickened ligament covering the two tendons (see illustration). This surgery relieves the pressure on those tendons and reduces the wrist’s pain and soreness.

Other Surgical Options

There are a number of other surgical options depending upon the injury or illness. With rheumatoid arthritis, for example, after removing the irritated lining over the swollen, inflamed joint, a surgical procedure realigns the tendons that have been distorted and are now out of position. If the joint is dramatically damaged, an artificial prosthetic joint can be used to replace the existing joint.

Joint fusion involves removing the joint and filling the space with a bone graft (see illustration). Bone taken from another area, usually the pelvic bone, is interposed in the space between the ends of the remaining bones. This heals in a fixed position so that the joint is no longer movable, and it is usually fixed in a functional position. A metal plate or rod is used to hold the bones in a fixed position.

Although some mobility is possible with joint replacement, joint fusion severely limits movement of the wrist. However, in spite of the reduced mobility, the now-stable wrist is still able to perform almost all of its normal functions without pain. Remember: good hand function still is possible with little or no wrist movement, as long as the wrist is pain free.