Wrist Reconstructive Surgery

Wrist reconstructive surgery is performed primarily to restore lost functions and relieve pain in cases of trauma, developmental deformities, or diseases.

The procedures for complete wrist reconstructions are:

• Anatomical reconstruction
  1. Primary reconstruction of the injured joint (reduction and internal fixation).
  2. Correctional operations (osteotomies).
• Restoration of function without anatomical reconstruction
  1. Partial or total arthroplasty
  2. Arthrodesis

Normal function can be best restored using anatomical reconstruction, but if it is not possible, other methods such as arthroplasty or arthrodesis are done to achieve functional repair.

In cases of trauma to the wrist, reconstructive surgery involves repair of the injured structure, reattachment of the lost portion of the hand or transplantation of muscle or skin flap taken from the forearm or other area of body to reconstruct the injured wrist. Repair of skin, tendon, nerve and artery lacerations are also done. Wrist fractures are also common during accidental trauma. These fractures may often become displaced and require surgical reduction and fixation with plates and screws.

In arthritic conditions of the wrist, a partial fusion or arthrodesis is performed to preserve joint function. Wrist reconstructive surgery is also necessary to correct congenital deformities such as radial or ulnar club hands, Madelung’s deformity (growth disturbance in the wrist causing a downward bend and a bump on the back of the wrist). Extensive burns on the hand can lead to deeper tissue loss and exposure of tendons. In these cases, reconstruction is done using a skin graft from the upper arm or back to cover the lost tissues. Microvascular repair of the artery and veins is done to restore blood circulation to the transplanted graft area.