# wrist fusion???



## nuggets (Jul 7, 2008)

I'm facing a wrist fusion and I was wondering if anyone else out there had the same surgery. I had a badly broken wrist that never healed properly and is loaded with arthritis. Went to many surgeons and the only way to control the amount of pain I have is to fuse the joint. I have had 2 total knee replacements, had my right arm reconstructed and I'm worried about this procedure.


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## lukey (Mar 7, 2008)

I had a partial fusion for something called "medial instability". It's usually a disease of middle age (worn out joint), but I had developed a pretty severe case by about age 16 or so. Main contributing factors were lots of falls and tons of hours on pre-suspension era mountain bikes...and a bit from other sports and traumas.

Anyhow...I won't sugar-coat this...the pain from the surgery completely reset the "10" on my pain scale. Quite intense. There are tons of nerve endings in your hands...and my hand was swollen to about the size of the thickest part of my thigh post-operation. It was like a giant balloon. Popeye styles. Yipes. For about a week, I was having trouble dealing with the pain levels. For at least a week, I couldn't lower my hand below my shoulder height or the throbbing would make me want to throw up/pass out. Sleeping wasn't really truly possible in any kind of normal way.

I'm a candidate for a second surgery on the other wrist...and I have hesitated mainly because it was a bit too much. I have never ever dealt with anything like that before or since. I never take pain killers, ever. My hospital files are like a phone book and I've had tons of injuries and lots of self-induced suffering on the bike, so I'm no stranger to pain. My parents (who both worked in emergency rooms) describe me as having extremely high pain tolerance. If I ever complained about something as a kid, my parents took me for an xray because it meant I had a fracture. So that was tough, but it ends fairly soon and you go on. Things improved pretty fast, and the pain was well-managed with lots of drugs etc.

There was a lot of soreness/weird feelings around the wrist joint for the first say 2-3 months, but the area on my hip where the bone donation came from was ultimately the most annoying thing after about a month. It seemed that my belt/pants etc put a lot of pressure in that area, and it kind of got more sore and inflamed before it got better. Today it it completely normal except for a small scar.

I think my cast came off after about 2-3 months. My surgery was in October, and I was back riding with no functional issues at all the following April. I would say that my wrist has never been _totally_ comfortable ever since. After a long ride, there are twinges here and there. But on the bike, in the bar-gripping position, everything feels fine.

In my case, My hand was essentially "dislocating" from my wrist, and since the surgery, I have a much more stable grip on the bike. Sometimes I used to hit a bump and have my arms essentially try to dislocate from my hands. Nothing like that now.

In terms of the bike, I've had to mess around with bars and grips a wee bit, to get the appropriate amount of bend angle to meet my hand...obviously, my wrist doesn't adjust at all to the bar any more, so the bar has to conform to me. I can't quite make full contact the way I used to, so on the fused side I seem to grasp the bar close to my thumb rather than on the heel of my palm. Feels ok though.

About 2 summers ago I took a fall from a height/stunt and rebroke the fused wrist. I'm extremely confident that the lack of movement contributed to the seriousness of the injury. I landed on both hands equally, but really jammed the one that was fused and chipped a bunch of the hand bones. Luckily, although I had shattered some of the bones in my hand, I didn't need a cast because I wasn't going to be bending anything. I couldn't really ride for about 5 weeks, but I didn't have any other major issues.

I snowboard a bit in the winter, and you get your hands on the ground a lot. I have mashed and jammed my fingers a lot, because I can't get my palm down in falls. It has impacted me a bit negatively there, because sometimes my fingers end up being too sore to ride again.

Well...that's what I can think of...


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## solocycles (Jan 30, 2008)

You need to find out from your doc exactly what he is going to do. There are several procedures for fusing different joints in the wrist. Not all would end your riding but a crash could make a bad thing a lot worse. Get the procedure name and do some on-line research, be an informed patient. Good luck.

Marty


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## nuggets (Jul 7, 2008)

With this procedure he is plating my wrist to my radius and then fill the bone with a donation. I'm supposed to have rotation but no flexion. I thought I may have to go from my riser bar to a cruiser style bar. It's like you said, you must now fit the bar to you hand.


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## 550 (Jul 26, 2009)

Anything fusion is bad news. I know plenty of people with spinal fusions, granted the scale is a bit higher. :-/ Fusion = bad.

Good luck man! Either way you will adapt.


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## lukey (Mar 7, 2008)

My "partial" fusion involved 4 small wrist bones...if I recall correctly: hamate, capitate, lunate, triquetrum. I believe I basically "lost" the midcarpal joint.

I ended up with only about 30% of the original flexion. I have very little ulnar/radial deviation (a little more ulnar in a position with my hand flexed down), but rotation (pronation/supination) are basically normal in my case.

I have rotation but not much flexion -- kind of what will happen with you.

Also...something I forgot to mention is that my surgeon originally told me that it would be an option to ride with a wrist-brace to protect my hand from injury if I fell. He offered to fit me for a custom one and asked me if I would wear it. I knew I wouldn't use it and so I've never even tried it out. It would probably be an option for you, I'm guessing?


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## nuggets (Jul 7, 2008)

My fusion has been completed and I'm 1 day out of surgery. This is a very painful operation but the ortho estimates about 95% relief from pain. That's what I was looking for. I have no flexion but I have a good bit of rotation. Next step is lots of PT. Should be ready for Spring riding.


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## dirtbiker71 (Oct 10, 2009)

larry, i had a complete fusion on 10/7 and want to ask about your experience. can you drop me an email?

thanks!
jason carnes
[email protected]


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## goncallf (Jul 5, 2007)

Hi Nuggets,

Coul you tell me how is your wrist?
I'm facing the same and Arthrodesis Wrist (Fusion wrist) is what my doctor suggest me.
After all these years could you tell me developments?


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## cyclelicious (Oct 7, 2008)

goncallf said:


> Hi Nuggets,
> 
> Coul you tell me how is your wrist?
> I'm facing the same and Arthrodesis Wrist (Fusion wrist) is what my doctor suggest me.
> After all these years could you tell me developments?


You may not get a reply. The OP has not posted for a few years

I had a fusion following a rt Colles fracture (fracture at the distal end of the radius) in 2009. I have a plate and about 12 pins. I have very mild limited range of motion in the joint (the difference is not noticeable even to my crossfit coaches) I have 100% strength and it has not prevented me from riding or weightlifting. No signs of arthritis due to the fusion

You do need to do exercises to help rebuild strength in your wrist and regain your normal range of motion. It takes several months to work on strength to previous level. I've been doing crossfit the past 3 years and I have surpassed my former strength. You might continue to have a dull ache or stiffness for about two years afterwards. I have no pain 8 years post surgery


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## jaydoc (Dec 24, 2014)

cyclelicious said:


> You may not get a reply. The OP has not posted for a few years
> 
> I had a fusion following a rt Colles fracture (fracture at the distal end of the radius) in 2009. I have a plate and about 12 pins. I have very mild limited range of motion in the joint (the difference is not noticeable even to my crossfit coaches) I have 100% strength and it has not prevented me from riding or weightlifting. No signs of arthritis due to the fusion
> 
> You do need to do exercises to help rebuild strength in your wrist and regain your normal range of motion. It takes several months to work on strength to previous level. I've been doing crossfit the past 3 years and I have surpassed my former strength. You might continue to have a dull ache or stiffness for about two years afterwards. I have no pain 8 years post surgery


I belive you you are substituting fusion for ORIF of a fracture. After a Colles fx, one would expect almost normal function. After an actual total wrist fusion, there is complete elimination of flexion/extension/radial and ulnar deviation.


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## bigwhls (Dec 6, 2010)

I had a complete wrist fusion in the fall of '15, absolutely zero range of motion now in the wrist and it SUCKS BALLS! Having said that, nothing will keep me off my bike. I was riding again 2.5 months post surgery (MTB, road was only 1 month) but the strength wasn't there and significant pain also remained, which probably had everything to do with why I crashed on 1st MTB ride back and broke my humerus. After recovering from that I was mtb'ing again by early spring '16, still with significant pain but the strength was better and I could control the bike better. For me the most difficult part was learning how shift again as it's my right wrist and you'd be shocked how much you flex your wrist when shifting. Once I got that down, and it still looks funny when I shift, I have to drop my elbow 60-70 degrees to reach the lever, I was good to go besides lingering pain at speed in the rough. Now nearly two years removed from surgery I barely notice the wrist, only in extreme cases does it bother me. I am just a couple years away from 50 and remain more than competitive on both the road and in a very competitive 40+ Enduro category. Make no mistake, a wrist fusion is hell, it will set you back significantly, it will cause you great pain, your forearm will shrink to prepubescent size due to muscle atrophy, but as long as you never forget the joy of riding, your mind will conquer the physical limitations and you will ride again.... 99% as fast as ever.

Ride fast, take chances.


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