Hands cannot perform its routine tasks without the use of the wrists. Hence, older individuals, who experience arthritis undergo various rehabilitative, non-invasive treatments to restore all or most wrist functions as soon as possible.
Unfortunately, cases of severe arthritis may cause patients to suffer from extreme pain and lose all functions of the wrist. It may also render the wrist unresponsive to non-surgical forms. This is where total wrist replacement comes in, also called wrist arthroplasty. Orthopedic instrument manufacturers provide orthopedic implants and medical devices to carry out the procedure of wrist arthroplasty.
Wrist Arthroplasty Surgery
The wrist is a complex network of bones, cartilage, and ligaments that each play a role in the smooth movement of the wrist. When the cartilage is worn away because of disease, injury, or infection, the bones of the wrist begin to rub against each other, causing unnatural wear on the ends. This is known as arthritis, which interferes with your ability to grasp objects.
Wrist arthroplasty involves removal of the damaged ends of the bones and replacing them with a synthetic joint, also called prosthesis. The prosthesis is made from medical-grade metal and high-quality plastic polythene and is intended to closely resemble the anatomy of the wrist.
The surgery can be performed under local anesthesia or general anesthesia, depending on one’s needs or preferences. An important point to note here is that modern wrist arthroplasty is performed on an outpatient basis.
Wrist Arthroplasty Rehabilitation
The first few weeks after surgery are spent wearing a cast that keeps the wrist in a neutral position to avoid swelling. Once the cast is removed, for the next 6 to 8 weeks, the patient must wear a protective splint. Total wrist arthroplasty rehabilitation spans anywhere from 3 to 6 months, restoring approximately 50% of healthy movement. The prosthesis lasts up to 15 years, depending on the physical demands of your everyday activities.
To prolong the life of prosthesis as well as resolve any complications at the point of time they occur, following up with orthopedic surgeon throughout recovery and every following year is the key to success. One also needs to work with a qualified physical therapist on pain management, and, eventually, exercises that restore endurance, strength, and range of motion.
Bone plates work like internal splints which hold together the fractured parts of a bone. These plates are available in all size, thicknesses, and shapes to suit the bone for which it is to be used. Over the years, developments in material science and engineering have led to the evolution of different shapes and size of the plates for clinical use.
In the initial phase of development of plates, surgeons such as Lane and Lambote used them to merely fix two bone fragments in approximate alignment. There were frequent Mechanical failures due to the metal reaction, inadequate design of screws and plates, etc.
The first use of interfragmentary compression by applying for plates under tension along the longitudinal axis of the bone was carried out by Danis, a Belgian surgeon in 1949. The concept was further explored and perfected thereafter by Muller and the AO group.
A bone plate has two mechanical functions. It transmits forces from one end of the bone to the other, bypassing the area of fractures and thus protecting them. Throughout the healing process, it also holds the fracture ends together while maintaining proper alignment of the fragment.
The names given to bone plates can refer to the shape of the plates (semi-tubular or one-third tubular plate), or some time to the width of the plate (broad or narrow plate). A name may be derived from the shape of the screw holes (round hole plate), or from the surface contact characteristics of the plate (low contact), or from the intended site of application (condylar plate).
Regardless of their geometry, configuration, length, thickness, or types of holes, all plates may be classified into four groups according to their function.
Neutralization Plate –
A neutralization plate transmits various forces from one end of the bone to the other, bypassing the area of the fracture and acts as a ‘bridge’. Its main function is to maintain a mechanical link between the healthy segments of bone above and below the fracture. Such a plate does not produce compression at the fracture site.
A plate used in combination with a lag screw is also a neutralization plate, counteracting the torsional, bending and shearing forces that tend to disrupt the screw. The lag screw contributes to the interfragmentary compression and stability. The neutralization plate merely protects the lag screw, allowing mobilization of the extremity.
In exceptional circumstances, a neutralization plate can produce compression at the fracture site, if the geometry of the fracture permits it.
The most common clinical application of the neutralization plate is to protect the screw fixation of a short oblique fracture of a long bone, or for the fixation of a segmental bone defect in combination with bone grafting.
Open reduction and internal fixation (ORIF) are one of the treatment options to fix a broken bone. It puts the parts of a broken bone together, so that they can heal. Open reduction means the bones are put back in their place during a surgery. Internal fixation means that special hardware is used to hold the bone parts together. This helps to correct the bone accurately. The procedure is done by an orthopedic surgeon using orthopedic implants & instruments provided by the orthopedic instrument manufacturers in India.
How do I prepare for a clavicle fracture open reduction and internal fixation?
Before ORIF physical and X ray examination of the site of injury is necessary. Doctor would like to get even details like the medicines you take, including over-the-counter medicines such as Aspirin. Also, tell your doctor the last time you ate.
Doctors might preform your ORIF as a planned process. If this is the case, ask whether you should stop taking any medicines ahead of time, for example, blood thinners. You will need to avoid drink and food after midnight the night before the procedure.
What happens at the time of a clavicle fracture open reduction and internal fixation?
An orthopedic surgeon and a team of specialized healthcare professionals will perform the procedure with the help of orthopedic surgery instruments obtained from orthopedic instrument distributors in Jakarta. The whole operation may take two hours. In general, you can expect the following:
- You will receive general anesthesia to make you sleep through the operation so that you would not feel any discomfort or pain.
- A healthcare professional will carefully monitor your vital signs, such as your blood pressure and heart rate during the operation. You may have a breathing tube placed down your throat during the operation to help you in breathing.
- After cleaning the affected area, your surgeon will make an incision through the muscle and skin near your clavicle.
- Your orthopedic surgeon will bring the pieces of your clavicle back into alignment (reduction).
- Next, your surgeon will secure the clavicle pieces to each other (fixation). To do this, she or he may use one or more of the Orthopedic Implants viz. bone screws, orthopedic plates, wires, and pins.
- Your doctor may make other essential repairs.
- Locking Reconstruction Plate 3.5 MM Staright is used for the clavicle fracture
- After the team has secured the bone, your surgeon will surgically close the layers of muscle and skin around your clavicle.
What happens after a clavicle fracture open reduction and internal fixation?
You may have some pain after your procedure, but pain medicine may help to lessen the pain. You should be able to resume a normal diet as soon as possible. You will probably require an imaging procedure, like an X-ray, to ensure that your surgery was successful. Depending on the extent of your injury and your other medical conditions, you may be able to go home that same day.
For a while after your surgery, you will need to keep your arm immobile. Usually, this means that you will need to wear your arm in a sling for several weeks. You will get instructions about how you can move your arm.
Your doctor might give you other instructions about caring for your clavicle, such as applying ice. Your doctor might not want you to take certain over-the-counter medicine for pain, because some of these can interfere with healing of bone. your doctor may advise you to eat a diet high in vitamin D and calcium as your bone heals.
You might have some fluid draining from your incision. This is normal. Let your doctor know right away if:
- You see an increase in swelling, redness, or draining from your incision.
- You have a high chills or fever
- You have severe pain
- You have loss of feeling somewhere in your body
Make sure to have all your follow-up appointments. You may need to have your staples or stitches removed a week or so.
At some point, you may need physical therapy to restore flexibility and strength to your muscles. Doing your exercises as prescribed can improve your chances of a complete recovery. Most people can return to all their regular activities within a few months.