Rationale:

After patient sustains an injury caused due to fall or accident, twists the wrist while playing sports, the patient undergoes intense pain and discomfort from swelling and it is clearly evident that an internal damage has been incurred on the wrist.  To inspect the internal damage and repair it, arthroscopy is the best technique of deliverance.

Approach considerations:

Arthroscopic repair is undertaken by the wrist doctor after the patient has persisting symptoms of enervating pain and stiffness in spite of being treated by nonsurgical techniques for a long period of time. It can be used as a technique of treatment for-

• - Alignment of broken bones
• - Removal of cysts
• - Removal of excessive joint lining
• - Repairing joint affected from Rheumatoid Arthritis

Introduction:

Wrist Arthroscopy is a minimally invasive surgical procedure which is used to identify and repair damaged tissues in the wrist that are causing its degradation. The procedure takes about 20 minutes to 2 hours to complete depending on the severity of the condition that is being taken up.

Preparing for the repair:

After physical examination of the wrist, the wrist doctor inquires into the past medical history of the patient to ascertain the allergies or reactions of the patient against certain medications. The patient is also asked to run some general medical tests to get a green signal that he is healthy to undergo arthroscopy. Prior to the surgery a set of instructions is given to the patient regarding prohibitory activities, consumption of medications, food or alcohol so that they do not interfere with the surgery.

Performing the repair:

After drugging the patient with anesthesia the wrist doctor makes small incision on the back of the wrist to insert a small optic camera to take an inside view of the ligaments and the cartilage surface of the bones. After inspecting the damage, the wrist doctor makes further minimal incisions to insert special surgical instruments to remove the severely damaged ligaments and repair the ones that are still clinically alive and can work normally thereafter.

Follow-up after the repair:

After the repair the wrist is bandaged to protect it from being moved and alleviate pain. The patient is released after the surgery and allowed finger movement so that they do not become affected by stiffness. The patient is provided with instructions regarding caring for the wound, rehabilitative program, activities that should be avoided and taking precautions to keep the wrist elevated.

Benefits Involved:

As the repair with arthroscopy involves smaller cuts and lesser disruption to the associated soft tissues than surgery, the pain that the patient goes through is much less. The swelling and the stiffness are also minimal and the recovery is much faster as compared to surgery. The patient is released on the same day of arthroscopic repair and thus does not have to go through anxiety pressure as with surgery.

Potential Risks:

As with any surgical release, arthroscopic repair involves some potential risks that may be subjected to change depending on a number of factors in each case. These complications may be in the form of –

• - Infection
• - Damage to the associated nerves, tendons or cartilage
• - Persistent stiffness after the surgery
• - Mobility loss in the joints
• - Weakness in the wrist

Rehabilitation:

Implementation of a well formulated and personalized rehabilitative program is an essential prerequisite for healing after the arthroscopic repair. The program comprises of protocols which enable the patient to learn pain management and gently stretch muscles to restore mobility and flexibility. It involves massages, therapy, exercises under the guidance of skilled physical therapist and after the surgery, with effective rehabilitation the patient gradually starts to move and work with the wrist normally.

More about wrist doctor:

Dr. Vikas Gupta at present the head of Shoulder and Hand Division at Max Healthcare is one of the best wrist doctors we have in India in the field of upper extremity in present times. He has an experience of more than 25 years in the field and has performed over 6000 successful surgeries.  Being an acclaimed professional who passionately believes in deliverance of techniques to relief his patients of each and any debilitation in the hand, he has a high success ratio in providing relief to his patients. As an MBBS and MS in Orthopedics from All India Institute of Medical Sciences, New Delhi and post graduate studies from Germany and USA, Dr. Gupta joined AIIMS as assistant professor to acquire experience when he started with his professional career. Gradually he gained finesse in his surgical impartation and tact in his diagnosis; he changed his forte from AIIMS to Fortis to Medanta-The Medicity. He has been credited for introducing many international and painless techniques and having been honored with many prestigious awards for his contribution he has emerged as an influential role model for his peers and interns. Dr. Gupta has a compassionate approach towards his patients that helps to ease their anxieties and his accurate diagnosis provides him an edge over other wrist doctors.Max Healthcare, being his present forte of deliverance is a super specialty hospital that believes in providing cost effective and painless techniques to their patients through international deliverance of techniques and a team of ingenious and dedicated professionals.