Wrist fusion surgery?
- Thread starter yopaulie
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Do NOT let a doctor talk you into fusing anything. Especially not without exhausting EVERY available option first.
10 years ago I had a doctor want to cut me open the same day to fuse a wrist I broke. I used that wrist to give him the finger and left. I'm perfectly fine 10 years later. My only discomfort is when trying to do a palm-up flatbar curl (which....I never do) and it tingles a bit. Actually, I was perfectly fine a few months later will full mobility and strength in that area.
What is the exact nature of your injury?
The doctor is not suggesting the surgery right now, he only mentioned it because he knows I want to ride hard again. I broke the triquetrum, scaphoid, and tore almost all the ligaments. The good news is that all is healed except the scaphoid. The wrist was in a cast for 2 months and a brace for 3 months along with using a bone stimulator but the scaphoid only has slight bridging with gaping around the screw. So the bone is severly compromised and may be dying.....
Wrist fusion basically makes your wrist 100% worthless as far as mobility goes, correct? It sounds like that would be an absolute last resort, like 1 step before amputation or something.
Pretty much correct....no up/down, left/right....but it will be crazy strong, no pain, able to twist, and actually able to ride.
There are also a couple other options like partial fusion and also removing 3 more bones. There is no doubt this was extremely traumatic to the joint and there is no way it will ever be the same.
I remember watching one of the outdoor MX races this year. They said Baggett still had zero wrist mobility after his surgery this year, and had to twist the throttle by moving his elbow. This really has nothing to do with your situation or this thread. I was just thinking about how gnarly that must be to ride like that.
Waaaaait...how can you twist anything with a fused wrist? You mean by extending your elbow while shrugging your shoulder? Sounds like crap.
Correct me if I'm wrong, but isn't a fused wrist what caused Cully to quit racing bikes a while back?
When I broke my scaphoid a few years ago, I was in a cast for much longer than 2 months before going to a brace. More like 2-3 casted above the elbow followed by a couple below elbow casts for 1-2 months a piece. And that was with no other damage in the wrist.
I don't know how crappy your blood flow is, but it seems that you could get a lot more aggressive with the immobilization of that joint.
Both of these are false from what I understand. It will be more prone to breaking again, just in a different part of your wrist/forearm/hand because there's no relief in your wrist bending.
I've also heard of people complaining from lingering pain from fusing.
Any doc worth a damn should have no problem knowing and expressing the limits of their usefulness and suggest seeing someone else for alternatives before suggesting fusing a wrist.
My bro Max had his wrist fused a few years back. He had injured it years prior to a snowboarding accident. When he got really into riding, he had to wear a brace all the time. Then it was too much for him to deal with I guess.
I don't know all the exact details from it, but dude tears it up. Rides moto too, even with it being the throttle wrist. It's his "robot arm."
I don't know all the exact details from it, but dude tears it up. Rides moto too, even with it being the throttle wrist. It's his "robot arm."
for once we agree.
go find yourself a good orthopedic surgeon that specializes in hands. then find another one for a second opinion.
I think his big issue, having dealt with a scaphoid break myself, is that he said he has a screw in the scaphoid, but the screw has not remedied the break. He mentioned the scaphoid is essentially not fused back and is in essence crumbling. That's bad, bad mojo.
But I DEFINITELY AGREE and insist you get a second opinion from a highly trained orthopedist, specifically a hand surgeon who specializes in nothing but what you're dealing with.
Even if you're going to an awesome specialist, get that second opinion. It's paid off for me twice in life. Won't bore you with the details.
But I DEFINITELY AGREE and insist you get a second opinion from a highly trained orthopedist, specifically a hand surgeon who specializes in nothing but what you're dealing with.
Even if you're going to an awesome specialist, get that second opinion. It's paid off for me twice in life. Won't bore you with the details.
Dam!!!That sucks Paul!! I second the second opinion and consider you ought to consider heading to boston for it. Hell, beers on me if ya do.
I do know someone who had his wrist fused. Still rides (very well I might add) but with a lot of pain. Very little range of motion in the wrist.
I would suggest (as others above) that you go and exhaust all other possibilities. And get many other opinions.
I would suggest (as others above) that you go and exhaust all other possibilities. And get many other opinions.
ScarredOne, the twisting really comes from your fore arm not your wrist....even in a working wrist.
I already set up the 2nd opinion to be sure where I stand and I was also wondering about the wrist being stronger because without any flex at all it may be more apt to break under major stress.
I will know where I stand in a couple weeks and make the decision then.
Thanks for all the input.....and Doug the next time I am down there it may be beers and pain killers!!
I already set up the 2nd opinion to be sure where I stand and I was also wondering about the wrist being stronger because without any flex at all it may be more apt to break under major stress.
I will know where I stand in a couple weeks and make the decision then.
Thanks for all the input.....and Doug the next time I am down there it may be beers and pain killers!!
Ive broken both scaphoids, and this was a real danger with mine also.
Seriously, best of luck to you.
I would advise the rest of you to consider riding with cti type wrist braces that limit the range of motion of your wrist, so you dont pop your scaphoid like a walnut.
This is a VERY common break in mtb and mx.
Once theyre on, you dont even notice them, other than you look like a robot.And robots are cool.
Seriously, best of luck to you.
I would advise the rest of you to consider riding with cti type wrist braces that limit the range of motion of your wrist, so you dont pop your scaphoid like a walnut.
This is a VERY common break in mtb and mx.
Once theyre on, you dont even notice them, other than you look like a robot.And robots are cool.
The wrist has the movements of flexion/extension, radial/ulnar deviation.
The way the ends of the radius/ulna in the forearm and their associated ligaments are structured allows pronation/supination. Not wrist flexion/extension.
Either way, sounds like you need a couple new orthos and some good opinions from docs who aren't quick to cut.
Paul, I would highly recommend getting an opinion from the orthopedic surgeon that put my non-healing humerus break back together, Dr. Jesse Jupiter.
http://www.massgeneral.org/ortho/doctors/doctor.aspx?id=16525.
He works at MGH in Boston and specializes in upper extremity procedures and is one of the go to surgeons for Boston professional sports athletes. I have an uncle that consulted and worked for the Patriots for years as a foot specialist and after I started having complications with my fracture he recommended that I seek out Dr. Jupiter. If you can get yourself in front of him, I would highly recommend it. Your injury is in his area of expertise, he is one of the authorities in this field (he is still a teaching doctor I believe for Harvard Medical), and he deals with athletes.
http://www.massgeneral.org/ortho/doctors/doctor.aspx?id=16525.
He works at MGH in Boston and specializes in upper extremity procedures and is one of the go to surgeons for Boston professional sports athletes. I have an uncle that consulted and worked for the Patriots for years as a foot specialist and after I started having complications with my fracture he recommended that I seek out Dr. Jupiter. If you can get yourself in front of him, I would highly recommend it. Your injury is in his area of expertise, he is one of the authorities in this field (he is still a teaching doctor I believe for Harvard Medical), and he deals with athletes.
Adult-film stage name?
If Loonatic ever checks in, he may have some advice. He broke his severely off a drop out at the Rampage site. I know it took some time and he still has hardware in there but I'm not sure that he's fused. He still rides but I don't want to mention the recovery period.
Who are you seeing locally? Dr. Anthony Mollano is a friend who works out of the Concord Orthopaedics group. He fixed up another friend after a pretty good ski wreck at Pats Peak. If that is not who you are seeing, he may be worth a visit.
Who are you seeing locally? Dr. Anthony Mollano is a friend who works out of the Concord Orthopaedics group. He fixed up another friend after a pretty good ski wreck at Pats Peak. If that is not who you are seeing, he may be worth a visit.
Inclag, thanks for the Dr info! Pegboy, Dr Mollano is my original Dr so its good to hear you also recommending him.
I'll keep my fingers crossed but I know Dr Mollano is a highly respected Dr but I will see after another opinion. After checking up on the subject it really looks like a full fusion is more durable and less prone to issues when compared to a partial.....either way I WILL ride again!
I'll keep my fingers crossed but I know Dr Mollano is a highly respected Dr but I will see after another opinion. After checking up on the subject it really looks like a full fusion is more durable and less prone to issues when compared to a partial.....either way I WILL ride again!
That dr j, is the man Paul. I was lucky enough to see him years ago and he is legit. It's always a good sign to see the pro athletes on the doctors wall with thank you autographs.
You'll be out there shredding by spring I'm willing to bet!!
You'll be out there shredding by spring I'm willing to bet!!
Speaking of Dr. Jupiter, just saw this on ESPN:
http://espn.go.com/boston/nfl/story/_/id/9806795/rob-gronkowski-not-yet-cleared-play-sunday-new-england-patriots-according-reports
Andrews is serving as an independent physician charged by the team and player with determining whether Gronkowski is cleared to play. Andrews is considered the most accomplished orthopedic surgeon in the world, but he didn't operate on Gronkowski.
Gronkowski also still has not been cleared by Dr. Jesse Jupiter, who performed the latest forearm surgery on Gronkowski, a source told ESPN NFL Insider Adam Schefter.
http://espn.go.com/boston/nfl/story/_/id/9806795/rob-gronkowski-not-yet-cleared-play-sunday-new-england-patriots-according-reports
Andrews is serving as an independent physician charged by the team and player with determining whether Gronkowski is cleared to play. Andrews is considered the most accomplished orthopedic surgeon in the world, but he didn't operate on Gronkowski.
Gronkowski also still has not been cleared by Dr. Jesse Jupiter, who performed the latest forearm surgery on Gronkowski, a source told ESPN NFL Insider Adam Schefter.
Just a heads up...I went to another Doctor and he agreed with the fusion surgery. The surgery is scheduled for 11/4.....I'll have to wait to next year to see how it is for riding and I assume I will be fine with skiing, outside of a funky pole plant, I should be good!
I crushed my wrist to bits and basically had a couple surgeries to put it back together to heal and then fine tune it and remove some hardware later.
I thought i may never ride again for a while.
Anyhoo, fusing it will negate some problems but you have to give up range of motion to do so.
I did not fuse mine but it was a serious option.
Certainly you are doing the right thing by seeing multiple specialists.
Good luck with it
I thought i may never ride again for a while.
Anyhoo, fusing it will negate some problems but you have to give up range of motion to do so.
I did not fuse mine but it was a serious option.
Certainly you are doing the right thing by seeing multiple specialists.
Good luck with it
Your question...is your answer.
if i were in your shoes i'd opt for opinion #3 just to be sure
I gotta head to work. I've broken both Scaffolds, and left one has been fussed for my whole MTBing life, over 15, maybe 20 years.
Get some comfrey. I'll write back later with more detail. I'd avoid fusing for now.
Get some comfrey. I'll write back later with more detail. I'd avoid fusing for now.
What's the downside to not fusing, seeing how it heals (or doesn't heal) and then reevaluating? My understanding is that if your blood flow is poor, and it doesn't heal, then the bone will start to die and decay. At which point you would just install some hardware and fuse it or something. I guess my questions is, how is that any worse than just fusing it now? It seems like there's no real benefit to being preemptive with this kind of surgery, and that you are potentially throwing away what could be a relatively "healthy" wrist. Especially given the super long recovery time of fusion surgery.
Disclaimer: I'm not a doctor, well, not that kind at least. I have broken my scaphoid (total break) and had it heal perfectly in ~5 weeks...but I was 20 years old at the time.
Edit: ooops just reread the first post, looks like you've already been trying to let it heal like this for 5 months.
Disclaimer: I'm not a doctor, well, not that kind at least. I have broken my scaphoid (total break) and had it heal perfectly in ~5 weeks...but I was 20 years old at the time.
Edit: ooops just reread the first post, looks like you've already been trying to let it heal like this for 5 months.
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You appear corrects. 4-corner fusion significantly reduces the forces on the scaphoid, but simply increase them elsewhere.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527225/figure/Fig2/
Cool, full paper here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527225/
The bone has already started to die....it is baking away from the screw internally and separating from the other half of the bone. The biggest reason that I want to get it fused is because I know how I ride....large drops, some on a hard tail, hitting everything at Highland minus some slope style stuff etc... When my wrists were good I have felt the deep impact through my wrists from big landings and I don't see how it would last. It makes sense about a rigid wrist would be a longer lever so I could potentially break something else but, that's DHing, with the **** we do anything bad is a possibility that we all take. What I do know is that I will ride again with a fused wrist but if I take the chance of a partial fusion and that doesn't work there goes another year.....at 45 I only have so many left! lol
Its funny.
45 seems SO OLD when other people talk about it.
Good luck with it all.Hopefully you can make it work enough to keep you happy
45 seems SO OLD when other people talk about it.
Good luck with it all.Hopefully you can make it work enough to keep you happy
in that case... avoid avascular necrosis
Jon, the avascular necrosis is basically what is starting to happen and I guess if you weren't aware of it and enough time goes by you can get bad arthritis in all the surrounding bones.
Canadmos, they could do some "joint replacement" but they are very weak by comparison.
Ski season first and next spring will be the real test....
Canadmos, they could do some "joint replacement" but they are very weak by comparison.
Ski season first and next spring will be the real test....
in that case get that sh*t fixed STAT. hope you heal up quick and strong
Thanks Jon!in that case get that sh*t fixed STAT. hope you heal up quick and strong
Good luck. Just remember doctor's orders:
