ADVANCED WRIST RECONSTRUCTION SURGERY

The goal is to reduce pain, inflammation, and instability while promoting healing and restoring function. 

Non-Surgical Approaches:

Rest and Immobilization: Resting your injured wrist and avoiding activities that increase pain or strain on the ligaments are crucial for promoting healing. Immobilization with a splint or brace may be recommended to limit movement and support the injured ligaments.

1. Ice Therapy: Applying ice packs to the injured wrist can help reduce pain and inflammation. Ice therapy is typically applied for 15-20 minutes several times a day, especially during the acute phase of the injury.

2. Compression: Compression bandages or wraps can help reduce swelling and support your injured wrist. However, it’s important not to wrap your wrist too tightly, as this can reduce circulation.

3. Elevation: Elevating your injured wrist above heart level can help reduce swelling by promoting drainage of excess fluid from the affected area.

4. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation associated with wrist ligament injuries. It’s also important to follow the recommended dosage.

5. Physical Therapy: A structured physical therapy program can help improve wrist strength, flexibility, and stability. 

6. Activity Modification:  Reducing strain on your wrist can help prevent further aggravation of your injury and promote healing.

7. Steroid Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation and alleviate pain in the wrist.

Wrist ligament repair surgery aims to repair torn or damaged ligaments in the wrist to restore stability and function and alleviate pain.

This surgery is often considered when non-surgical treatments such as immobilization, physical therapy, and medications have failed to provide relief or in cases of severe ligament injuries that compromise wrist function.

Indications for Surgery

• Severe ligament tears that do not heal with conservative treatment.
• Chronic wrist instability or pain that affects daily activities.
• Significant reduction in wrist function or range of motion.

Types of Wrist Ligament Repair Surgeries

1. Open Repair: Dr. Pournaras will make an incision over your wrist to repair the damaged ligaments. This method is often used for more severe or complex injuries.
2. Arthroscopic Repair: This uses small incisions and an arthroscope (a thin tube with a camera and light) to guide the repair. This approach generally results in less pain and a quicker recovery than open surgery but may not be suitable for all ligament injuries.

Common Procedures

• Ligament Reconstruction: Damaged ligaments are replaced with grafts taken from tendons elsewhere in the body. This is often necessary when the original ligaments are too damaged to be directly repaired.
• Direct Ligament Repair: The torn ends of the ligament are sewn back together. This is typically feasible only in acute injuries with healthy ligament tissue.
• Capsulodesis: A procedure to stabilize the wrist by tightening the joint capsule and ligaments, often used in cases of chronic instability.

Recovery Process

Recovery from wrist ligament repair surgery varies based on the type of surgery performed and the severity of the injury. 

• Immobilization: Your wrist is often immobilized in a splint or cast for several weeks to allow the ligaments to heal.
• Physical Therapy: After a period of immobilization, physical therapy is essential to regain strength, flexibility, and function in the wrist.
• Gradual Return to Activities: Dr. Pournaras typically advises to slowly resume normal activities, with a total return to strenuous activities only after several months.

Expected Outcomes

The goal of wrist ligament repair surgery is to restore stability and function to the wrist, reduce pain, and improve the patient’s quality of life. While many patients experience significant improvements, the outcome can depend on various factors, including the severity of the original injury, the specific ligaments involved, and following the post-op directions.

Recovery from wrist ligament surgery can vary greatly depending on the specific procedure performed, the extent of the injury, and your health and response to surgery. Here are some general guidelines and stages you might expect during your recovery:

Immediate Postoperative Care

• Pain Management: You will likely experience some pain after surgery, which can be managed with medications prescribed by Dr. Pournaras.
• Splinting or Casting: Your hand may be immobilized with a splint or cast to protect the repaired ligaments.
• Elevation: Elevating your hand above your heart can help reduce swelling and pain.
• Early Rehabilitation

• Physical Therapy: After a period of immobilization, physical therapy usually begins. It’s crucial for regaining strength and flexibility but will be tailored not to strain the healing tissues.

• Gentle Range-of-Motion Exercises Initially, exercises are gentle and aim to slowly increase mobility without compromising the surgical repair.

• Progressive Strengthening

• Increased Exercise Intensity: As healing progresses, the intensity of exercises can increase under the guidance of our physical therapist.

• Gradual Return to Activities: You’ll gradually be allowed to resume more strenuous activities as strength and flexibility improve.
• Long-Term Recovery and Rehabilitation

• Continued Physical Therapy: Therapy may continue for several months depending on the surgery’s complexity and the desired level of function.
• Follow-Up Care: Regular check-ups with Dr. Pournaras or our hand therapist, who will monitor your recovery and address any complications.

Factors Influencing Recovery

• Type of Surgery: Different procedures have different recovery timelines and challenges.
• Patient Compliance: Following Dr. Pournaras and our physical therapist’s instructions closely can increase your recovery speed and give you the best outcome.
• Overall Health: Pre-existing conditions, such as diabetes or rheumatoid arthritis, can affect healing times.

 

Tips for a Smooth Recovery

• Adhere to Post-Op Instructions: Follow all post-operative care instructions provided by Dr. Pournaras.
• Stay Active Within Limits: Engage in approved activities to promote circulation and healing, but don’t overdo it.
• Healthy Lifestyle: A healthy diet, adequate rest, and avoiding smoking can facilitate a quicker recovery.

When to Seek Help

• Signs of Infection: Fever, increased redness, or discharge from the incision site.
• Severe Pain: Unmanageable pain or pain that significantly worsens can indicate complications.
• Lack of Progress: If you’re not seeing improvement over time, discuss this with Dr. Pournaras.

Recovery times can vary widely; some patients may recover in a few weeks, while others may take several months. Maintaining realistic expectations and communicating regularly with Dr. Pournaras and our medical staff is essential.