The process of wrist replacement surgery is described through a patient testimonial, giving a run-down of the factors applicable to surgery of the wrist and hand.<\/p>\n
Wrist replacement surgery is now available in Malaysia. KASMIAH MUSTAPHA finds out who qualifies for such a surgery MD Yusoff Musa is now a happy man. He is no longer on painkillers and is able to sleep better and go to work. The first person in the country to undergo a wrist replacement surgery, he is slowly regaining the use of his right hand which, for the past six years, had caused him severe pain.<\/p>\n
He had broken his hand during a fall in 2004. Although he had felt a slight pain at that time, the 46-year-old thought nothing of it. However, after a week, his hand started to swell. When he finally went to see a doctor, he was told that he needed an operation to repair a broken bone.<\/p>\n
Unfortunately, as a result of the operation, he can no longer move his wrist.<\/p>\n
His hand became stiff. He could barely used the hand as it was too painful. Being right handed, it was very difficult for him to do any kind of work. Even lifting a piece of paper caused pain to run through his right upper limb.<\/p>\n
\u201cWhen I asked the doctor about it, he said it was a normal condition after the operation. But I do not think it normal to still have pain years after surgery.<\/p>\n
I could not sleep and eating was difficult. I was constantly on medical leave because I could not do my work.\u201d<\/p>\n
For six years, he tolerated the pain through painkillers. However, over the years, his body was no longer responding to the medication as it has become immune to the drugs.<\/p>\n
He felt a solution had to be found, so he sought a second opinion at a private medical centre. The doctor referred him to the hand and microsurgery unit at Pantai Hospital Kuala Lumpur.<\/p>\n
His timing could not have been more perfect because the hospital had just acquired the technology for a wrist replacement surgery. When told that he would make a good candidate for the surgery, Md Yusoff was overjoyed.<\/p>\n
\u201cI was so happy when the doctor told me that they could do the surgery, which would not only give me a new joint but would also leave me pain-free.\u201d<\/p>\n
The surgery was done in June. He is now undergoing physiotherapy to build up the weak muscles on his right hand and upper limb.<\/p>\n
Pantai Hospital consultant orthopaedic hand and microsurgeon Dr Ranjit Singh Gill said Md Yusoff was suffering from post-traumatic arthritis, a common condition that develops years after a fracture or ligament injury.<\/p>\n
\u201cIn his case, the fracture had healed but it left him with a very painful and stiff wrist. His wrist joint suffered an inflammation as the bone did not heal and the cartilage started to wear out. Over the years, he had not been using the hand properly and was on pain medication. As a result, his body no longer responded to the medication and his kidney began to suffer.<\/p>\n
\u201cWhen he came to us, I told him of the options \u2014 to either do a fusion surgery or have a total replacement. He was more than willing to have the replacement surgery. \u201c<\/p>\n
According to Dr Ranjit, Pantai Hospital is the first in the country and the region to offer wrist replacement surgery. The hospital acquired the technology since March. This procedure is currently only available in the United States and Australia.<\/p>\n
Wrist replacement surgery is suitable for people who suffer from post traumatic osteoarthritis and rheumatoid arthritis. It is also suitable for those who suffer from diseases that attack the joints, such as lupus, he said.<\/p>\n
\u201cHowever, not everyone can immediately have the surgery. We will start with medication, physiotherapy and a simple operation to solve their problems. Wrist replacement is only suggested for people who are in severe pain and when medication no longer works.\u201d<\/p>\n
Treatment for those suffering from wrist arthritis includes avoiding activities that cause pain, immobilising the wrist in a splint, giving anti-inflammatory medication and steroid injections into the joint. Surgery using wrist fusion, or partial wrist fusion and partial resection of the wrist bones can also be done.<\/p>\n
Dr Ranjit said that in wrist fusion surgery, the joint is removed and the bones at the base of the hand and in the forearm are fused together. The patient will no longer suffer pain but will still have use of their hands. However, the patient will suffer from loss of wrist movements such as flexion and extension.<\/p>\n
\u201cIn the wrist replacement surgery, we remove the diseased joint but we will maintain the bones and ligaments around it. We will then replace the removed joint with an artificial one. The implant has solved a lot of problems as it takes into consideration all the wrist movements.<\/p>\n
\u201cOnce the implant has integrated with the bones, tissues and ligaments, a person will be able to use his wrist normally. This will usually take three months. We will start the patient on physiotherapy after the surgery to help them regain the range of motions.\u201d<\/p>\n
The Re-Motion total wrist replacement is a surface replacement implant that requires minimal bone removal and preserves soft tissues and long-term surgical options. It comprises three primary anatomically designed implants: Radial, carpal ball and carpal plate.<\/p>\n
The radial component is designed as a surface replacement requiring minimal resection of the radius bone preserving the peripheral rim with its important ligamentous and soft tissue attachments.<\/p>\n
The carpal plate component is a low profile design that minimises the amount of bone resection and does not interfere with the normal function of the wrist extensor tendons. The carpal ball component articulates with both radial and carpal plate, which results in enhancing motion. The cost of surgery ranges between RM20,000 and RM30,000.<\/p>\n