Wrist arthritis - 4 corner fusion?

[RideReady]

I've had problems with my wrist for quite a few years.  About 6 years ago, I had surgery for arthritis in my thumb where the surgeon removed a bone.  Up until a few months ago, things have been good.

While out working in the yard, I felt a pop in my right wrist.  The pain has continued to get worse - to the point where it is painful to pick up a cup of coffee.

I went to a hand surgeon - he gave me a cortisone shot and said if that works, he'll continue with the shots until they don't work any longer.  Then the surgery he recommended was a "PRC" to remove 3 bones from my wrist.  The first shot did absolutely nothing.

So, went for a second opinion.  This doc said to definitely NOT have a PRC as based on the arthritis in my hand/wrist, I am not a candidate for it.  He said it wouldn't work and I'd end up with more issues as time went on.  His recommendation was to do a 4 corner fusion and remove the scaphoid bone.  The diagnoses was advanced capitolunate arthritis.

Has anyone had a PRC and then had to do a fusion later on?  Or has anyone had a 4 corner fusion done initially?  What were the outcomes?

The doc did say that with the 4 corner fusion, I would lose about 50% mobility.  From what he said the recovery is about 12-16 weeks.

Now I'm wondering if I need to see a third surgeon..  I don't want to mess up my wrist any more than it already is

 The picture is a printout of the xray the second doc took

[Turboloader]

Ouch!

[D E D]

Pretty much the same thing with my wrist but the only surgery I had was carpal tunnel - the pic is from around 2 yrs ago - my surgeon pretty much gave me the same options - I asked him if it was his wrist what option would he choose knowing that I work with my hands/ride a dirt bike etc - he advised not having any surgery until the pain was unbearable - that said I think I remember him saying that if/when some of the bone collapses you’re kind of &%$#@!ed  - wasn’t really paying attention at that point - looking at the X-ray and the surgery options kind of numbed me out - I’ve been taping my wrist when I ride which helps but it’s pretty painful when I get a sharp hit or or crash with my hand out - Rubbing DMSO on my wrist helps to reduce the swelling/pain - you might want to try that - a cortisone shot didn’t help at all

 

Edited October 25, 2020 by D E D

[RideReady]

@D E D oh man...  The second doc said it was totally up to me when I opted for surgery.  He said I could wait a couple years - or basically when I couldn't stand the pain any longer.  Guess he knows at some point I'll be back.  I tape my wrist and it helps some, but like you - if I fall on that hand, I'm in pain for a few days.

The second doc said I shouldn't get the PRC as, if the remaining bones "drop" or shift they don't have any cartilage left on them so if they start wearing against the radius (think that's what he said), then I'll be in worse shape than I am now.

Thought about getting a third opinion, but decided not to.  I'm going to try and hold off as long as I can for surgery.  The frustrating part is that I've lost strength in that hand.

[Brett_41]

I dislocated the left lunate about 13 years ago and had surgery to repair. (see X-ray). It was reasonable for around 7 years then the arthritis set in to a point that there is only about 30- 40% movement now in both directions. I have a "SLAC" wrist which is Scapholunate advanced collapse. Then I fractured the Scaphoid two years ago which never healed. Doc who fixed the wrist the first time told me to come back when I couldn't stand the pain. He doesn't recommend a PRC or a 4 corner fusion as he says I'll be back for a full fusion later anyhow. His thoughts are that I will certainly be riding again after the fusion. I trust his judgement. I'm 58, ride/race almost every weekend and all I do is tape the wrist up. Wrist doesn't bother me riding but there is always as least slight constant pain all the time.  The pain is certainly not at a level to consider the fusion but realistically, I'm probably only one good crash away....

Edited November 5, 2020 by Brett_41

[NoFiddyPilot]

On 10/13/2020 at 2:51 PM, RideReady said:

I've had problems with my wrist for quite a few years.  About 6 years ago, I had surgery for arthritis in my thumb where the surgeon removed a bone.  Up until a few months ago, things have been good.

While out working in the yard, I felt a pop in my right wrist.  The pain has continued to get worse - to the point where it is painful to pick up a cup of coffee.

I went to a hand surgeon - he gave me a cortisone shot and said if that works, he'll continue with the shots until they don't work any longer.  Then the surgery he recommended was a "PRC" to remove 3 bones from my wrist.  The first shot did absolutely nothing.

So, went for a second opinion.  This doc said to definitely NOT have a PRC as based on the arthritis in my hand/wrist, I am not a candidate for it.  He said it wouldn't work and I'd end up with more issues as time went on.  His recommendation was to do a 4 corner fusion and remove the scaphoid bone.  The diagnoses was advanced capitolunate arthritis.

Has anyone had a PRC and then had to do a fusion later on?  Or has anyone had a 4 corner fusion done initially?  What were the outcomes?

The doc did say that with the 4 corner fusion, I would lose about 50% mobility.  From what he said the recovery is about 12-16 weeks.

Now I'm wondering if I need to see a third surgeon..  I don't want to mess up my wrist any more than it already is

 The picture is a printout of the xray the second doc took

Not sure where in FL you are, but if you're in/around Tampa, I recommend a 3rd opinion from this guy:

https://find-a-doctor.health.usf.edu/provider/Francisco+Alberto+Schwartz-Fernandes/726106

Interesting story, his father was a dr. and when he was a boy in Brazil, he cut the ends of his fingers off with a table saw. Doctors were able to save them and he grew up to be a micro hand surgeon. He did a tendon repair for me and I was super happy with the result and he's a good to deal with. No attitude, takes his time and he actually seems to give a you know what about you.