Welcome
I started this blog because I needed a proximal row carpectomy and I could not find any further information other than how the operation is performed and statistical results of the operation. I had many questions that were left unanswered. For example, how much pain will I have during the operation, after the operation and how long will it take to heal? When could I start using my hand and more importantly my fingers? Would I be able to ride my motorcycle again? And if yes how soon?
I searched blogs, Bing and Google and could not find any answers to these questions. Of course I could find out what was involved in the operation and during operation including all those gory videos intended for surgeons and horror movie fans. So I decided to start a blog to log events and I urge anyone else who has had a proximal row carpectomy to add their comments or ask their questions to this blog so that it may help others. Additionally please share your experiences as well!
There may be some grammar errors since I’m using Dragon Naturally Speaking software to dictate the entries rather than typing. I hope to catch most of them.
Proximal Row Carpectomy - PRC 
I am 4 weeks post op from PRC and still in a hard cast. I was in a half cast wrapped with ace bandage for the first week and at that point they took it off, took out staples and stitches on Palm (I also had a CTR at the same time) and they put the hard cast with a removeable elbow brace that keeps my elbow steady. That part was to be worn all the time for the next 2 weeks and then wanted me to start taking it off and moving small amounts.
Wednesday will be 4 weeks and I also go in that day to (I think) get this cast off and I ASSUME get a brace, although I am not positive what they’re gonna do. I am still in a fair amount of pain to be honest, and I’ve had my fair share of surgeries including another surgery I had on this same wrist 2 years ago in an attempt to repair the ligaments. I am moving the 4 fingers pretty good but not without pain and my thumb has been immobilized for 4 weeks now (YUCK)!
I had a PRC on my left, non-dominant wrist on August 4th 2014 when I was 17, now 18, due to various problems with the bones in my wrist, but mostly due to the degeneration/death of my scaphoid (avascular necrosis) as it was severely broken (there was no trauma which was weird) and lost all blood supply. I am having real trouble with pain as I have been diagnosed with complex regional pain syndrome, but my thumb is the biggest problem. I have no idea what is wrong with it,
but there is a sharp pain whenever I try to move it. Any ideas? I am from the UK and currently studying for some very important exams and I find it really hard to concentrate both in lessons and at home when completing work due to the significant amount of pain I am in. Prior to the PRC surgery, I had many cortisone injections into the joint, but these were unsuccessful in treating the pain. I also had another surgery as my scaphoid and trapezium were fused together from birth
but there had been a break so my surgeons had to use a tendon graft to hold the bones together, however this was also unsuccessful. How long can I expect the recovery to be? Any suggestions on ways to reduce the pain would be gratefully accepted. Due to the overuse of my right wrist, it is, too, becoming incredibly painful, especially on the ulnar side of the wrist. I have had x-rays on this wrist and it has confirmed that it isn’t the same as my left but there were some problems with it but my surgeons did not discuss them with me. Is anyone else experiencing this? Should I be worried about this?
Hello again Kelly! thank you for the reply. I have gotten referrals from other doctors in Ohio and Seattle with recommendations for more hand surgeons in Oregon which I will be contacting after I see my original surgeon and see what his response is.
The lunate on my right hand was also crumbled in stage 4 by the time I went to see the hand surgeons both in my area and up at OHSU. The hand surgeon near me in Medford OR was all about fusing my hand. He never diagnosed it as Kienbachs but said the horse broke it. He never offered any other form or surgery besides a fusion. that is why I went up to OHSU in Portland which is a teaching hospital. The doctor there immediately told me the horse did not break my hand but I had Kienbachs, first time I had heard of this. I was adamant to him that I would not have a fusion. He said he was not going to fuse it but do the PRC. At that time anything sounded better than a fusion but now I am re thinking it all after seeing what a 4CF is and reading comparisons on medical sights about 4CF vs PRC. It doesn’t seem to be much difference but all that I read indicated the PRC was more painful, longer recovery and about the same ROM. So I am now going to entertain a 4CF but I plan this time to consult with as many certified hand surgeons as I need to so I can be satisfied. One thing of interest to me is that if I get the fusion, I will have first hand ( a pun!??) knowledge of which is the better option for my condition and will let this forum know down the road.
Kelly, I would ask you if it is not too intrusive, could you ask your surgeon for his opinion of the 4CF vs the PRC and share it on this list? I think it would be most helpful to all of us and future people facing this type of operation.
thank you and continue to heal as well as you are! the sand sounds great! I will look into this. You should look into the hot wax bath! OMG it feels so wonderful I crank it up to warp heat and it is a little too hot at first but the wax stays so warm until I peel it off and put it back into the bath. Love it!
again, thank you for your response!
amber
Hi Kelly, amber here again. I am shocked and delighted that your PRC went so well. I also want to comment on the shooting pains. This is what has been the constant in my post op recovery. As I think I mentioned above, it starts about two inches up my wrist on the base of my thumb side. It is not all of the time but it does happen a few times every day and this is going on almost two years. If your doctor can tell you what is causing this will you please share with the rest of us, particularly me? I see my surgeon in a few weeks and I hope he has some answers for me.
I also want to mention the reason I was shocked at your post is that my fingers were still swollen at almost a year post op. I could not wear any of my rings. My PT and his PT wife showed me things to do to try to get the Lymph system moving to get rid of the swelling, but it still took forever. The one exercise that helped me the most was the use of putty. OMG. It was so soothing, it was unbelievable and it gave my fingers so much motion. Even my two young granddaughters loved to play with the putty because it was so comforting. You can buy this therapeutic putty on amazon. I still sometimes use it just because it puts me in such a peaceful state of mind. Another thing I bought on Amazon was a hot wax bath. My PT had me dip my hand in wax at his office every session before we started the PT. It was heavenly, so much so that I bought one myself. It will help with surgery of the hand and arthritis. You can also dip your feet in it if you have problems there. It is awesome.
Did your surgeon mention having a 4CF instead of the PRC? I am most interested in hearing from anyone that took this route over the PRC. I just cannot fathom going through another PRC. I have a lot of questions to be answered on both procedures.
I will be interested to know too, if I am again at stage four with my left hand. I know as of October when the images were taken that the lunate has not crumbled and I didn’t see any cracks in it either so maybe there is hope for a re-vascular blood supply but I am not counting on that.
Please keep this blog informed on your recovery. I am most interested!
best of luck to you, Kelly.
amber
Hey Amber! I see my doctor on Monday, so I’ll see what he says about the shooting pains. My fingers are still a little swollen, but not nearly as bad as they were after surgery. I’ve kept ice on them a good bit. I’d say they’re back to pre-surgery size, but not back to the size they were before I had Kienbock’s. I’m not holding my breath that they’ll ever be back to normal size! I agree about the putty! It feels so good! My favorite thing so far has been the “sand box”. It’s a machine that you put your hand/wrist in and it pulses warm sand (I assume it’s sand). They said it helps with sensitivity, etc. It feels amazing! He did not mention the 4CF. My bones were very dead. They were fibrous material when he removed them. Fusion wasn’t an option. PRC was my only option. I will keep you posted. Best of luck to you as well! Hopefully you get good news about your other wrist!
I am 25 years old, in Louisiana. I have Kienbocks disease as well. I had pain and swelling in my left wrist for a year before I was diagnosed. I was stage IV, the worst. I was shocked at the diagnosis, as I have never heard of this!! I have done SO much research on Kienbocks. I had no other treatment options, as early stages do. I am two weeks post op. I had the PRC, and he also had to shave my radius. I have an excellent surgeon. He has seen many other Kienbocks patients, so knew what needed to be done. I got the bandages off and into a splint after 5 days. The stitches came out after 10 days. I have therapy three times a week. I’m back to full function with my fingers. Working on my wrist. After being in pain for an entire year, the pain from this surgery has been minimal. The only irritant is the nerves and tendons are going crazy in there. I have weird shooting sensations. Anyone else have this? What can I do to make it stop?? If anyone from here needs a surgeon recommendation, in Louisiana, please let me know.
Thank you for your response, Debbie. Just to further inform all, I went through almost three months of intense PT. I bought and was given by My PT aides to use at home. Weights, putty, stretch bands, a wax machine, many other items and I was and still am faithful to using them almost two years post op. With Kienbachs Disease one doesn’t know how bad it is normally until it reaches stage four which was the case with my first surgery on my right hand. The bone was crumbled by the time I went in for a diagnosis. I have seen the images on my left hand and it has not reached the crumbled stage and until I can get a surgeon to look at it all I have no idea what stage I am in. It is a strange condition. On my left hand that is now compromised it was one day just fine, the next day swollen and painful. It just does not come on gradually to offer any warnings.
I did my follow up visits with the surgeon up at OHSU. I did not go back to find out why I am having constant pain because it was to the point that I wasnt going to allow any further surgery on my hand no matter what. I just live with it because nothing to me will be as bad as another operation and lengthy recovery and who knows what the outcome will be. I am way too active running an equine ranch to take the chance again.
However, I did find conversation on this blog of great interest. That being that I am changing my thinking about a 4CF. I watched a lot of you tube videos on this procedure and it is not as invasive as I had thought. I have been reading comparisons between 4CF and PRC and I now want to explore the option of the fusion. I just cannot imagine anything worse than the PRC, even a fusion. I am wondering if my right hand can be fused with a 4CF after a PRC? I have read opposing opinions on this. On my post op hand it feels more like a nerve or tendon problem, it is about two inches up my arm from the wrist/thumb base. Not where the three bones were removed and it comes on out of nowhere, a sharp stabbing pain. It will wake me up out of a sound sleep.
I am grateful to have found this blog and bless the person that started it. It is almost impossible to find anyone or any forum on Kienbachs Disease. I typed in PRC and was lucky to get to this forum.
By the way…. glad the gentleman brought up the butt wipe. It is a HUGE PROBLEM!!! but what the heck when both hands are useless? I’m not as agile as I once was so learning to use my feet to wipe seems unreasonable. Perhaps we on this group can devise some apparatus and go on Shark Tank and become millionaires so we can then hire everything done for us cripples!
I am going to Mexico in February 2015 and I will not have any surgery done before then.I need a vacation and no surgery is going to mess that up. So I have some time to do research. My appt with OHSU is December 16 and boy howdy! I have a lot of questions for this doctor and he has some ‘splaining’ to do for me.
Again thank you all for the replies.
Hi, I wanted to tell you I am 55 years old and had a PRC in 2008. From my experience, it took me a full 15 months to get to be 90% pain free. I really think you should have gone for your follow up visits. I too felt this was the most painful surgery ever! My hand surgeon did follow up PT and even an injection months later. I remember being one year post op and felt completely frustrated with the every day constant pain. I was nearly in tears in the doctor’s office. At that time, he sent me back to PT for something called iontophoresis. I did this three times a week for about six weeks and it made a world of difference. Granted, I do not have Kienbachs Disease but I’m sure you needed some post op physical therapy. If there is one thing that having this injury has taught me, it has made me be patient with healing. It’s been over six years since my surgery and I’m completely satisfied with my results. I know if I have used my hand too much and I try and make sure it gets a little more rest for a couple days and it’s back to feeling good. I also had a great hand surgeon who did not give up on me. I also remember seeing pamphlets on Keinbachs Disease in his office so I would certainly wonder about anyone who calls themselves a hand surgeon who has never heard of that disease. My hand surgeon is not one to mix words and he expects you to follow his direction. I have no doubt he would be advising you to allow your hand to heal before doing many activities. I think he tends to be a little cast happy but then again I probably needed somebody to be firm with me. 🙂 I can also understand other hand surgeons that do not return emails. I completely understand your frustration with their lack of response but you must look at it from their view. They cannot advise anybody without an examination. This is in part due to the malpractice issue. Please do not give up. From what I’ve read about Keinbachs Disease, you have your best chances of successful treatment if treatment is started early. Unfortunately I live in northwestern Pennsylvania or I would recommend my hand surgeon. Look for a surgeon who will be willing to work with you long term and I think you will find the success you are looking for. Good luck in your journey!
In February of 2013 I had a PRC for a rare disease called KIENBACHS DISEASE. this seems to be what several of you had too but are not using the correct name. VERY FEW doctors have heard of Kienbachs Disease including the first certified hand surgeon I went to. Less than 200,000 people in the US have this condition. I refused to have my hand fused, wrist replacement was not in the picture for me because I trained horses and was too active to guarantee a replacement. I went 300 miles away to Portland OR OHSU teaching hospital. The hand surgeon there immediately diagnosed it as KIENBACHS DISEASE. He said a PRC would be the best course of action for me. This happened in my right hand which was dominate. I have had 16 prior surgeries in my life and I will tell you I have never had such a long painful recovery. It is almost two years post op and my right hand is still very painful going up the wrist. It feels more like nerve damage now. It was such a horrible surgery I decided to not go back to the surgeon that performed the PRC and just live with it. My reasoning was that no matter what is causing this pain, I will never let anyone do another surgery on my hand. It is that awful. I can barley open anything, I drop things constantly and the pain is daily even waking me up from sleep during the night. Now remember, I am a very strong, active healthy woman with a very high pain tolerance. In other words, I am not a wimp to pain or injury, hence 16 operations for my dare devil life.
Two months ago my left wrist swelled up and was/is painful. I thought it absolutely cannot be KIENBACHS DISEASE again since it is so rare. I finally got x rays done locally and had them send the images up to OHSU to my hand surgeon there. His first thoughts since I have not gone back to see him but have an appt on December of this year 2014 is that I again am the very unlucky and extremely rare person to have a second Kienbachs Disease. I am ready to shoot myself. How could this be?? I am so depressed I don’t have enough words.
Trying to get information on this disease is almost impossible. I have called, written, emailed four HIGHLY recommended hand surgeons across the Pacific Northwest to get more opinions on this and not one of these doctors has had the courtesy to reply. I am pissed off like you cannot believe.
What I want to ask one of these super human doctors is what really is the best procedure for this? I have always refused to have bones in my body fused, starting with back surgery in the mid 1980’s when all the doctors fused the spine. Now however with this pain and loss of use of my right hand I am open to anything that will be better than PRC.
If you want to know how disgusting this surgery and its recovery were try this ( women or men can borrow from their wives/girlfriends or Victoria’s Secret) try to put bra on with only the use of your non dominate hand! I learned to use my feet, teeth, elbows. It was THAT BAD! I was still using my left hand to do things like eat for almost 4 months post op!
I can now put a bra on but to go through this misery again is just too overwhelming. I am ambidextrous since the surgery because my right hand is almost useless. What will happen once my “good” left hand is subject to another surgery? why isn’t there more information on this disease and surgery? Are there any doctors on this group?
If any one has had a fusion of the wrist I am all eyes to read your current status. Please give me some hope…or not.
I had my PRC done in 1991 in Vancouver after a failed carpal replacement by an older physician in 1988 that did not have the knowledge required to properly assess my condition. At the time I was told I would likely need a full fusion within 5 years…it is now 2014 and it is as good as it was post surgery 1991 no fusion yet! Choose your specialist carefully and you should have no problems enjoying everyday activities.
I am a 53-yr-old active female who had a PRC on Aug. 1, 2014 and it was one of the best decisions I have ever made! I had torn the scapholunate ligament many years ago and didn’t realize it. By the time I found out, it had disintegrated and could no longer be repaired. My carpal bones began to separate (7cm!) and constantly rub which caused severe arthritis in my wrist. My right (dominant) wrist was constantly in pain, but when I bumped it, the pain was excruciating! It took me several years to make the decision to have the surgery, but the longer I waited the less options I had. By the time I decided on surgery, the doctor said he could only “salvage” my wrist, not repair it. My options were a PRC or a 4 corner fusion. We already planned on the 4CF, but I changed my mind a week before the surgery b/c the recovery period was quicker with a PRC, with almost the same end results. I’m so happy I chose the PRC!! Before I had the surgery, I had zero flexion and extension and very little motion moving toward my thumb and lots of pain. After many weeks of occupational therapy, I now have quite a bit of flexion, but still very little extension. I know I will no longer be able to do a push up, but I do wall push-ups on my knuckles or fingertips.My wrist strength is slowly coming back, but I also need to build up the rest of my arm/hand muscles because they had atrophied so much. My recovery went great. Swollen fingers and hand for a week or two, but the pain wasn’t unbearable. The best thing I did was to keep moving my fingers and touching my thumb to each of my fingers, which kept the swelling down. The worst part of my recovery was having to wear a cast in the middle of the summer heat! I hope my experience helps others to make the right decision for themselves. I did a ton of research before making my decision and was grateful for these forums that let people tell it like it is. Good Luck!! 🙂
Oh, I forgot the most important thing – my pain has diminished almost completely and it gets better every week. Again, I know everyone;s case is different, but for me, I know I made the right decision choosing a Proximal Row Carpectomy.
I elected to have PRC surgery after being told all the tendons were torn in my left wrist and were beyond repair. I’m heavy into working out and knew this would greatly affect my performance. Almost 3 yrs out and I’m still unable to perform floor push-ups(did up to 250 per day 2x/week), and flat bench bar and a variety of other routine exercises. I strictly stick to DBs for chest and a lot of other exercises as its less painful. I have been slowly inching up to the 100lb DBs for chest but its been a long process. Overall I’m happy with surgical outcome bc the other intense pain is no longer an issue. Advice: if you box wrap your hands&wrists!!! This is where I believe I tore all my hand tendons. Any ?’s regarding PRC surgery feel free to email me. Cnfzednlife@yahoo.com. Ryan
I just had a PRC on October 2nd because my lunate collapsed and fragmented. After surgery I was in a lot of pain and it woke me up in the middle of the night for about two days. The swelling has gone down a lot, but my fingers are still very bruised. I was placed in a removable cast last Tuesday and I am getting the stitches out this coming Tuesday. The recovery has been very difficult for me because I use a wheelchair for mobility and I cannot use my hands for at least another two weeks. I need help with everything I do and it is frustrating.
Well, I am up against all of this now too. I currently have lots of pain in my wrist – but still have full motion in my hands and fingers (at this time). I have been told I have a intrasseous cyst in the distal pole of the scaphoid bone. Along with 5-6 mm space in the scapholunate area. So I have been told my options could be a full scaphoid exision, a 4 corner fusion or a PRC. None of these sound good to me at all. I wonder what would happen if I did nothing. I have read all the comments above about PRC and some sound promising some not so much.
Any words of advise.
Debbie, I cant speak for everyone but I will tell you my experience after PRC. I had it on both wrists due to the extreme pain I was having from arthritis. I am a heavy equipment mechanic so the use of my hands are extremely important. I was told before the surgery the exact opposite you were told. The PRC takes longer for recovery. It involves the removal of a whole row of bones in the wrists. The bones in my wrists were dying and tendons coming off of them so I really didn’t have much choice. It has been over ten months since my surgery on my right wrist and four months on my left wrist. They are both extremely weak compared to before the surgery. I still have pain, stiffness and the mobility sucks. I bought an electric weed eater because I cant pull start a gas weed eater. I tried weed eating my back yard a couple of weeks ago and had to stop every 1-3 minutes to rest the hands and three fingers on the right hand went to sleep and still don’t want to come back after two weeks. They feel like they are shocking me. It is a sensitive subject but here goes. The worst thing since surgery is wiping my own butt after going to the bathroom. The hands don’t bend the way they use to so you can imagine. Social Security has accepted me for disability and the doctor has released me from his care even though he said the mobility in my left wrist is worse than the previous visit. Any time I pick something up with any weight it feels like my hands are going to come apart. They have already replaced me at my place of employment and I was told by the company nurse that she would never ok me coming back with the restriction I have on my hands. The long term disability insurance company knows I have been accepted for SSD but they want more proof I cant work any where or they will quit paying me. Now who do you think would hire a 62 year old mechanic that has had his back fused and PRC’s on both hands. I am going to another hand clinic in a few days for another opinion from another doctor. I will post what he tells me. I hope I haven’t discouraged anyone. My pain is much better in the wrists than before the surgery. Then it felt like I put my hands down and someone smacked them with a hammer.
David, I am so sorry to hear about the lack of success with your procedure. However your doctor did not provide you with the correct information. Believe it or not, the PRC procedure is in fact the quickest and least painful to recover from. The fusion requires many little wires and supports drilled into the little bones. The procedure is far longer and the pain and recover is far greater than a PRC.
I also can imagine wiping your but since I now do it with my left hand and not the right (PRC) hand. I could but it would be an effort an not as effective.
Unfortunately, the reasons for a PRC vary considerably and have direct affect to the recovery and long term success. If you already had much arthritis, the PRC may not have being the best solution?
If you wish to pursue a better solution, you may want to contact my surgeon Dr. Steve McCabe who now performs complete wrist replacements for people with extreme arthritis and pain.
As I had explained in my video, I had a lot of swelling and lack of movement due to inflammation which often feels like arthritis. You may want to have a look at Wobenzym Plus and start eating for inflammation. There are cookbooks out there and I have noticed a huge difference. In fact, when I cheat I feel it the next day in the form of stiff fingers.
I wish you luck and remember that full recovery after a PRC takes a year or longer.
Thank you for all of your thoughts and advice regarding wrist salvaging procedures. I am an active 53 yr. old female who is preparing for surgery THIS week. I was asked to decide whether I prefer the PRC or the 4 corner fusion. Although I am leaning toward the PRC, I am not sure that it’s the right decision for me. I have SLAC wrist and am in constant pain which radiates up to my shoulder. The limited movement in my wrist causes severely painful tendonitis in my elbow and this is my dominant hand. From what I am told, the PRC typically is a less involved surgery with a quicker recovery, but there is a chance of more arthritis in 10-20 years. Also, I don’t think this surgery will provide the best stability to my dominate wrist. The 4 corner fusion is a much more involved surgery with complications including possible non-union of the appliance to the bone, infection due to the screws and appliance being rejected by the body, and a longer recovery period. Also there could be problems with impingement from the foreign object in your body. Both surgeries will relieve the pain, but I was told neither one is better than the other in regards to the amount of mobility and strength after surgery. Does anyone know if your wrist is considerably weaker after a PRC and is there a possibility of strengthening it during therapy? I’m hoping your thoughts will help me in my decision. Also, I’m praying for guidance.
Well, here is the way I look at things. The arthritis is definitely something that will develop much quicker because of the lack of natural cartilage between the bones. However, my surgeon has already performed many wrist replacements and in 10 years from now, that procedure will most likely be perfected, the materials used will be better and it will be a solution fort severe arthritis. I also you can limit the onset of arthritis (slow it down) by diet and exercise.
The other thing to consider is that you can try the PRC route and if after a year it is not working you can then get the fusion. I know that I do not have a tremendous amount of wrist movement compared to others, but the movement I do have has enabled me to do the things I love such as riding a motorcycle.
Did you watch my last video of after one year?
I am 60 years old and initially had a Tri-Scaphoid fusion because of a torn ligament in my hand. I had my first tri-scaphoid fusion in July 1983 and because not enough donor bone was inserted I had a second fusion in Feb 1984. I had full use of my had until about mid 2005 when my range of motion and strength was reduced and my pain level increased. I had my PRC in Mar 2006 and was initially quite happy with the results. However, I am currently suffering more pain and my range of motion have decreased to the point where I am again seeking medical care.
Hello. I broke my schaphoid approximately 3 years ago. I am 36 and have been a roofer for 20 years. Had a cast put on and was told not to work. But as I am the owner of my own business I could not afford the luxury of simply not working. So my schaphoid did not mend. Over Time I realized that I must get it treated. So I went to an orthopedic and
found that my condition was worse then I expected. Bone was pulverized so it could not be pinned and grafted. Had proximal row carpectomy approximately 11 weeks ago. Da
y one after surgery was rough.got home from hospital and as the anesthesia wore off I was in extreme pain. Docter gave me 5 mg Percocet. Was told to take no more then 2 every 5 bours and they gave me exactly enough to last me until my next appointment with the doc 3 days later. The pain was almost unbearable. And I am a man who is used to living with pain.I did as I was told for from three in afternoon until 8:00 am the following day. When I called the doctor
and practically yelled at them. They gave me 40 more pills. Why did they not tell me I could take more if I had too? I suffered all night. Anyway I went back to light duty 3 weeks later. I would be lying if I said it wasn’t extremely painful. and I was surprised at how much my forearm bicep and pectoral had atrophied in only three weeks. By week six I was feeling significantly stronger. Now at week 11 I am able to do everything. But still having pain of course. But it is improving everyday. my flexibility though is another matter altogether. I have almost none. Can anyone tell me how long until it is fully healed?. Meaning it is as good as it is ever going to be?
It could take up to a full year before completely plateaued
Fantastic. This was well worth it then. Thank you
I am a candidate for PRC. Diagnosed with SLAC wrist due to playing drums for many years – aka “percussionist wrist”. I am also a computer programmer.
To cut to the chase, here is the defacto study of PRC from renowned Johns Hopkins University. http://www.ncbi.nlm.nih.gov/pubmed/23809467
Did you know when this PRC procedure was first introduced ???? Over 50 YEARS AGO!! Yes 1960s.. This is a destructive procedure not reconstructive. Eventually, after losing those bones the remaining tissue and bones have to pick up the slack and aren’t up to the job.
What is amazing to me is the advances in repair of ligaments and tendons, etc with knee injuries. I wonder if money has anything to do with it?
I was hoping to find some stem-cell reconstructive treatment and possible repair or relief – but it will have to be in another country. Looking now if anyone has found anything let me know. I am not interested in going to Mexico… no offense meant.
It is destructive but when the lunate bone is brittle and dead, there are no alternative fixes yet. Once they perfect the materials, they will be able to create a new wrist.
It appears that a PRC is the least obtrusive of the 2 procedures. (PRC vs Fusion). If that is the case then should that be the one done first ?
I was in a splint for about 8 days then the stitches were removed and a cast was put on. I had to wear the cast for about 3 weeks. I tried to use my fingers to type, but could not. After the cast was removed I kept trying to use my fingers.. I did not give up! I think using the computer was great therapy! I think you will know what you can and cannot do.
I am 59years old and have suffered with painful wrists for several years. Diagnosis was SLAC. (arthritis). Have seen 2 specialists. One says PRC. Other says partial fusion. Am going to see 3rd Dr. Next week . My questions will be if fusion is still possible after PRC or vice versa. At this point status quo with pain relief would be the goal. I might add that both my brothers also have wrist issues not as bad as mine. Any comments or suggestions would be appreciated. I am retired so work would not be an issue.
The way it was explained to me, fusion is not possible after PRC because bones are missing. PRC is not possible after fusion because the articular surfaces of the fused bones have been altered in order to foster the bone-to-bone fusion. So it really is one or the other, with the condition of the bones themselves and the cartilage, as well as the patient’s age determining which is the better choice in a given wrist. The very specialized hand/wrist specialist in SF with whom I consulted said he recommended scoping first (even at the time of the surgery) to guide the choice, because the imaging techniques don’t tell the whole story, so it’s hard to tell from them which is preferrable. He could not recommend for me without taking a look inside, for example, just said those were the two possibiities.
You can have a fusion after a PRC. I had a PRC and they said that the next step if it was not successful would be a Fusion or wrist replacement. The fusion is when they take the existing bones and wire them or screw them so that they do not move and therefore will not have an affect on the nerves and tendons to eliminate the inflammation and pain (I stand to be corrected because I am not a surgeon).
Kurt, see my reply below about my choice to have the PRC.My doctor knew I was in so much pain before the surgery that he said I would love him AFTER the surgery because the PRC would get rid of most of my pain (and it did!) I questioned him extensively about what happens if I develop arthritis 20 years later and he said that there was only a very small chance that that would happen, but I could then get a full fusion. He said I would’ve been happy with a full fusion before I had this PRC surgery because my wrist had already lost most of its mobility and any of the surgery choices would greatly diminish my pain- which was my main objective. My first choice was to diminish the pain, second was to improve my strength, and last was to increase my mobility. Three months later I am almost pain free, am pretty happy with my mobility, and am working on my strength. Good luck. You’ll be fine!
Today I was told that the PRC was probably a great option for me. I am 61 and about 30 years ago I broke my wrist. Evidently there was also some tendon damage. One of the small bones is significantly displaced too. Since i had a knee replacement 8weeks ago..my wrists have played a larger role in my rising from a chair. A year ago i had my first knee replaced so for well over a year, my wrists have been under extra duty. The feeling was that the extra chores they have had, resulted in the pain and the reduced mobility. Im going to splint it for a month, see how things feel, and reevaluate again in early May. If I can get the pain to subside and regain a bit of strength so I can fully function in the kitchen, I will be quite happy. Although there is a lot of arthritus, Im pretty sure most of my body is enjoying that diagnosis. (meant as a joke)
Thanks to all for telling your honest story. I hope to continue to follow your progress as i make my decision…
Oh yea…Columbus Ohio and most definitely a hand surgeon was consulted.
I hope all goes well with your surgery. Keep us up to date with your progress 🙂
Im wondering if anyone knows if I can do more harm than good starting to lightly use my hand before I was told to, when I woke after surgery my surgeon was already gone, I live 10 hours from the hospital I had surgery, but at day 8 I was back for a follow up appointment but my surgeon wasn’t there, just one of his interns, so I haven’t had a chance to talk with him, now I don’t go back till 7 weeks after surgery, Ive read different things about when its best to start rehab, I am at day 14 and I can do some things, I am even typing this. Also I am wondering what type of splint everyone has, I had a custom one made for me on day 8 but I was quite swollen then and now that the swelling as come down the custom splint is very uncomfortable, can I just buy a basic splint from the drug store
I can not give out medical advise however If you review my log entries you can see pictures of the splint then brace. I would not remove the splint without consulting a doctor.
it is a removable splint, plastic on one side and velcro straps on the other. I was told by the intern I could take it off for a few minutes a couple times a day to wash my hand and stretch
It is possible to customize a custom splint by adding stick-on memory foam pads. The hand therapists use it to make custom splints comfortable and to adjust them as needed. I’ve been supplied with pieces to use as needed to keep splints comfortable and workable. It might be available at a medical supply store, or maybe you could order it online.
A better bet would be to call the surgeon’s office and ask either advice or for a referral to a hand therapist near you to get a new custom splint made. I suspect there’s a particular angle you should be in post-op and a pharmacy splint won’t necessarily do the right thing.
(Note: I have not had this surgery but have had 5 hand/wrist surgeries so far and have more experience than I care to think about when it comes to hand/wrist splinting.)
You are doing better than I was. I had my surgery last May and it took me many weeks to get my fingers moving. I did not start therapy for about 6 weeks after surgery. There are a lot of things that I can not do. One of my wrist bones was dead, fractured and had a cyst inside the bone. I found that typing was good therapy.
I had my surgery on march 11 of 2014, just 13 days ago, my lunate began dying 6 years ago, I had an unsuccessful bone graft done 3 years ago, which lead to more pain and problems. I have not started any rehab or therapy yet, but I am very happy with the results so far. All my fingers are moving as well as my other hand, I have only slight numbness and some tingling, the pain comes and goes. Not much movement in my wrist but definitely some but again, I am just 13 days post-op. I think I am probably doing better than many others who are months into recovery.
My surgeon (Dr. Steve McCabe) and his partner in Kentucky did the first wrist replacement. They have done many since the first and are awaiting for long term results and statistics. The way I look at this is that I had a PRC done today and that in 10-15 years from now if arthritis gets bad or other issues develop, they will have perfected the wrist replacement procedure and I would have it done. He had told me that my wrist was not bad enough for a wrist replacement at this time.
Onur-can, I’m definitely not telling you to not have the surgery. I am however, advising you check out every option before making your decision to gave a PRC. I have no idea what part of the country you live but I will paste a link for a site I found with the top 45 hand surgeons in the country. I would recommend you contact one that is closest and get a second opinion. At a point that you find you are educated enough to make a decision, then you should proceed. I hope the best to you!
http://www.beckersspine.com/lists/item/3374-45-of-the-best-hand-upper-extremity-surgeons-in-america
The Dr. I used specializes in this surgery also. He told me there was no other option. If you don’t get it done the hand gets much worse, believe me. When they took exrays of my left wrist it showed that a tendon had already fallen off of one bone and was down in the arm somewhere. The more the bone dies of the worse it gets. I got to where I was coming home from work and packing my hands in ice. to keep the swelling and pain down to level where I could stand it. This has taken away my career. I am a heavy equipment mechanic at 61 years old. I was sure hoping I could work until I was 63 but a fall off of a piece of equipment backwards in the middle of the night that knocked me out with no one around scared me bad enough to find out why my hand were failing me. I would think I had plenty of grip to hold on to a railing then the pain would hit and the hands let go. I woke up with a pool of blood behind my head on the concrete floor with no one around to help. So it is obvious that I had no choice but t get something done with my wrists. It is not a great cure but it is better than the alternative.
I would not recommend a prc you are a young person. I have had one on my righr wrist for 6 monhs now. It still swells, has limited movement and is a lot weaker than before the surgery. The left wrist jjust got done on March 6th 2014 and the jury is still out on that one. I really did not have any other choice on mine if I wanted the pain to stop. The pain was horrific and made me want to stop living sometimes. at least that awful pain is gone.
Anything I ever read about PRC was not recommended for younger people. I had mine at age 50 and have found pain relief wonderful. This does not come without limitations though. In my opinion, You will never be able to do a push up again as the wrist won’t allow it to bend in that position. This is just one of the many things you cannot do. I would be skeptical to have this done at age 19 without researching all possibilities. One question I have for you. Are you seeing a hand specialists or a general orthopedic surgeon? You need a hand ortho surgeon and you need to research every option available. Once those bones are removed, you can never go back. Are your parents helpful with your research and decision making? You need a good support group and some great professionals that will show you every option available. I would travel the country to help out my son or daughter to find every option available before performing this surgery on a 19 year old athlete. Please think very long about this before making your decision.
The Hospital (specialized on hands, elbows, and micro surgeries) i was asking for other options said that a prc is the only thing they can imagine due to the stadium IIIb. I’m sceptical about the fact that this is the only way… To be honest I don’t want to give up my sport. Can you tell me a bette way? Where I can use my hand in a “normal” way? Or do you know if there is a possibility for an implantation? I’m really desperate since they told me I will loose a huge part of the strength in my hand.
What will happen if I don’t take the surgery? – I know that it will hurt more and more but I could still use my hand like I do now, even if I’m not really pleased with it
If you do not take the surgery you will be like me whereby over time the lunate dies, gets brittle and basically cracks or implodes into pieces under the pressure. For me it was changing a spark plug on my Vespa – OUCH!
Hi. Myself got the diagnose of a lunatum necrosis. The doctor said the only successful way of rescue my hand is a prc. I was wondering if there are other possible ways of an operation. I’m almost 19 and an American football player and some kind of scared. The doctor said I will loose some of my strength… Is it that noticeable? Do you regret it? Would you take an implant Maybe? I’m very thankfull for any kind of helping tips
Hi,
I can not say I regret it because it was the only option. Am I satisfied personally? not yet. I fear that I still have more operations in my future because of a bone fragment. however if you read some other comments many others are really satisfied. I had asked about an implant and was told that they had not perfected the material yet and it was not strong enough. They also mentioned that they had not being around long enough. Does mine hurt? no. Do I have loss of movement due to stiffness and a bit of swelling? yes. I do not have the same strength. About 55% of the other hand. With this procedure, it is not about a cure but it is rather more about getting you back to your lifestyle as best as it can be (never the same). I find that I am always aware of my hand. For example, you never reach out to open a door from the inside such as a public bathroom in fear that someone else may be coming in and the door would hit your hand while you are reaching out to open it. That would hurt! When it hurts, it takes a few days to settle down. Stuff like that….
Peter, I left a comment earlier this month venting my frustration with my progress. Needless to say ,we are all more or less in the same boat. It’s as you mentioned, it takes time and patience. I’m feeling much better this past week. With that said, I just wanted to thank you for taking the time to get us all connected and able to vent . may the good lord bless and heal you.
Thank you for your comment, it is truly appreciated. I fear that I will go back under the knife late fall AFTER THE SUMMER to have a bone fragment removed and the base of my thumb re-modeled slightly. Although my wrist really does not hurt so much the thumb is always stiff and seems to be the source of my finger issues. I will post the x-ray later today or tomorrow. My hand is better than before but I think it should be far better than it is.
Thanks for taking the time to comment I really appreciate it. I am seeing a hand specialist as well as other hand and wrist specialists in the dance community to gather as much information as possible. As well I have a saint austio/physiotherapist who’s worked with Circ.de.Sol and the Mtl Alouettes. Basically the reason a PRC was suggested is because my ligament is supposed to heal itself however my doctor does not think that it will. That being said, this surgery would relieve pain and my use, surgery or not, would be the same. Very limited. Also I think the reason he didnt recommend the 4 fussion is because i’m a dancer who trains every day and puts my body threw extreme physical endurance. This being said, i’m not sure a 4 fusion would hold or be my best option.
Also, ways that you can help yourself if ever you trip or fall from a dancers point of view: (As a clumsy person the risk of me falling is too high, even though im a dancer, once i learn this technique you never notice me falling or tripping because it’s done so smoothly and quietly).
Hold your arms inward, not crossed in an X position, but side my side with the palms towards your chest. When falling, human instinct is to throw our hands in front of us to catch us from falling on our faces or bums. If you are falling forward INTERNALLY rotate your leg so your knee points towards your other leg, your body will follow and you will fall in some form of weird fetal position. Practicing this technique is a great way to create body memory so if ever you fall you wont have to think about it, you’ll protect your body automatically. For falling backward, you want to perform the same internal rotation and you will fall again in the same position on your side. IMPORTANT to take note of: Your knee internally rotating will protect your knee cap as well as soften your fall to the floor. Holding your arms inward may seem scary at first, but its way better than reaching for nothing and falling on your poor wrists. Your bicep is cushiony and so is you bum/hip section of your body. They are meant to soften your fall. Falling backwards is a lot harder to master, however I feel its all in the body’s rotation. Use those obliques and dont just back flop on the floor or ice, rotate that body and use your cushions to absorb the ground in your fetal position. If you are in the Montreal area K.G. Guttman and Kelly Keanen are technical dancers who practice this type of absorption.
Hopefully you understand the gist of my explanation and I hope it’ll serve you well in your future god forbid you fall. Just remember, fight the human instinct to put your hands out, arms side by side with palms towards your chest. Even if you dont rotate quick enough, in my opinion its much better to fall on your stomach that way than risking further complication with an injury you’ve already come so far with.
Good luck and thank you for you help 🙂
Thank you, Samm! No one has taught me how to fall, and I am in the position of facing a possible PRC or fusion due to a ligament torn during a fall (while on crutches immediately following a foot surgery which was due to a fall…). It wasn’t the only problem, but seems to have been the last straw for my wrist. A head injury left me with a balance disorder and I am now especially prone to falling. I often need to use crutches, and really need my wrists. I have watched children learn how to fall in martial arts and may try to set something up to work on it on my own to avoid future injuries.
Given your age and the fact that yours is a partial tear, has anyone talked about the possibility of stem cell or similar treatment to promote healing/regeneration? Here’s a link to an abstract of an article about it: http://www.ncbi.nlm.nih.gov/pubmed/22242032
When I consulted with the top notch hand/wrist surgeon in San Francisco who works with professional musicians (and has replaced 8 joints in my hands), he recommended that I avoid surgery if possible, because none of the currently available options are very good and have mixed results. But to give it months, not years. He also was of the view that any wrist should be scoped before deciding between fusion and PRC, because which is the best option is dependent upon the condition of the tissues, at a level unobservable on an x-ray. He could not recommend the one surgery over another a priori.
I wish you thorough healing,
Trish
Wow, well if a human ever weighs as little as a computer or grocery back I’ll be sure tomy partner with them. I’m guessing it’s the pain that is limiting you from doing more than your capacity?
Well this gives me lots to think about considering my other wrist is already shot as well. Thanks again imensally!
I had a PRC on my left wrist (non-dominant hand) about 7.5 months back due to scaphoid bone dying. I think mine has turned out better than most, not as good as a few. But I’m happy with it. In terms of what I can and can’t do…The range of motion is about half of what it is with my good wrist (in terms of moving my wrist in the direction of the palm and opposite the opposite direction). In terms of the motion involved when I make a fist and rotate my wrist in the plane of my thumb and pinky finger, I probably have only 25% (and maybe less) of the range of motion of my good hand. When it comes to me being able to apply weight or lift with my PRC hand, it is all about the angles. I can’t do a traditional push up. I can’t get the 90 degree angle between the hand and forearm to do the pushup. I can do push-ups if I use a bar (like those perfect pushup things you might see on TV) and position my hand correctly. I can support my weight on parallel bars (if I have the angle correct). I can pick up a 20Lb bag of dog food with my left hand. I would like to think that I can still do all the things I need to do with my left hand/wrist, I just need to pay attention to the angles, when I do it.
I have to admit that I don’t understand your ligament issue. What little I’ve been able to read on the internet always seem to involve bones that have died or chronic arthritis as the reason for the PRC. I think the dividing line regarding the age of 35 relates to younger people having a more active lifestyle that might put them in a position of forcing their wrist to go beyond the angles it can achieve after having the PRC. For example, I could probably go out and play some touch football or play softball, but the odds of me putting my left hand out to brace my fall could very well force my wrist beyond an angle that it can safely achieve. In my own mind, that alone would probably force the joint to fail with the only fall back being a full wrist fusion. One of my big fears (besides getting eaten by a shark) is that I will trip or slip on ice and put my left hand out to break my fall. Does that make sense?
You do not mention whether the doctor you are seeing is a certified hand surgeon. If you are not talking to a certified hand surgeon (hand specialist), then you need to. If the right bones are not damaged in your wrist, then a 4 corner fusion is an option. I get the impression that a 4 corner fusion is more durable and is recommended for people under 35. I haven’t seen anything that says there is too much difference in range of motion or strength when comparing 4 corner fusions to a PRC. But if the fusion takes and you don’t have any hardware failure, I get the impression that it can better take the wear and tear associated with being younger. The recovery period is longer for a 4 corner fusion, compared to PRC. I had the option of 4 corner fusion but chose PRC because it was my non-dominant hand and because the recovery time was shorter (if everything went as expected). If I ever had a problem with my right wrist, I would seriously consider a 4 corner fusion. And if the 4 corner fusion does fail, it might still be possible to fall back on having a PRC. If a PRC fails, the fall back is total wrist fusion.
Unfortunately, you can see from this web site, there is a wide range of possible outcomes. Maybe this is too much info but I hope it helps. Make sure you are talking to a certified hand surgeon and not a regular surgeon and not even an orthopedic surgeon.
Good to know as well as knowing my wrist will act more as a hinge than ball in socket. Post surgery, I can’t remember how long it’s been for you, are you able to bare or receive weight on your wrist? For example, if I’m thinking of my profession, could you lift, pull or support someone else’s and or your own body weight? If so, for seconds or does it truly depend on the day.
As a dancer i often take b-girl poses baring all my weight on my wrist (135pounds) as well as lift or support others body weight.
Thanks again you’re an amazing help!
I do not think that I will ever be able to bear my weight on my wrist. I can lift things but I have to be careful about the weight. Nope, personally I cannot. I can lift a bag of groceries, yesterday I shoveled snow and ran the snow blower for hours, I lifted a computer desk alone, I ride a motorcycle, but if I wanted to push myself up with my right hand from a lying down position to sitting, I think it may hurt.
I’ve taken a few anatomy courses and basically because it’s a partial tair we can look at my ligament like a frade piece of wrope. It’s holding on by threads now but will regain it’s full wropes strength.
A FULL tare of a ligament is as if our ligament is still a rope holding the eight bones of our wrist in place, however this rope has been cut in two. It will never heal fully and physically tying it back together is the only way.
Although mine should heal 100% because it’s a partial tare it’s very unlikely. I’ve devoted already half a year with no use and my waiting will go over a year if I wait for surgery in December.
I’ve been doing some research and apparently PRC surgery doesn’t take well with people under 35. I am 21 in March of this year and regardless of the waiting time, because this is a 95% guarantied needed surgery, I’m starting to worry about long term effects such as arthritis and short term such as taking over a year to heal fully much like in the studies I’ve read.
Do you have any additional information on the age of the successful patients and an average heing time?
Thanks again for all your help it’s much appreciated !!!
Hi,
Yes, you should be concerned about arthritis. My surgeon explained that I would be more pronged to arthritis now since there is no natural cartilage between the remaining bones.
I have been suggested to have a PRC Surgery on my left wrist. I am a professional contemporary dancer which means my entire body is my career and success. I was told i had partial tearing in my TFCC and other small ligaments between the lower four bones of the wrist. It has been half a year now and surgery is officially on the table. I was asked whether or not I wanted to wait till December of this year to allow my ligaments to possibly heal, although unlikely said by my Dr, or to have the surgery performed ASAP. I am currently getting my Bachelors of Fine Arts at Concordia University and although I am powering my way through the past year with one arm, i’m not sure if waiting is my best option.
I was wondering if there were any amongst you who do sports or, like the mechanic, need to use your wrist in strenuous ways on a daily basis. If so, how significant is the loss of motion? Is the pain the only thing limiting you from performing longer more demanding tasks with your wrist? Is it worth saving another six month wait to possibly but not likely avoid this surgery?
Any help would be greatly appreciated. I will most likely be needing this surgery regardless, so i’ll be sure to post my recovery for you to monitor.
Hi,
Wow, a dancer! Well, if it is at all possible for your ligaments to actually heal, then I would take the time off to allow for that in lieu of the surgery. From the blog feedback it appears that 30 % who have the surgery have excellent results. But you are clear that your wrist becomes a hinge and no longer a complex joint. Your body seems to make up for the loss of movement in many ways such as using your arm to turn, shoulder etc… In my case, I have lost much movement but have no pain. others seem to have more movement but pain. Again, if it is possible for the ligaments to heal, I would do what ever it takes to promote that before having the surgery. That is my nonmedical opinion.
If I would have had any idea of the end result of my PRC I would have gotten a third opinion and even after that, I would have put my arm in a sling for at least 6 months and prayed for a healing before opting for the surgery.Asit stands right now,Im doing much better than some comments that Ive read,I can deal with the pain and stiffness,asit lessons week by week what concerns me is the weakness I am experiencing.I am now in my fourth month after surgery and I still cant do simple tasks,like openning a bottle cap or eating with a spoon,shavingor tieing my shoe. I have to wonder if I’ll ever be able to swing a hammer or ride my harley m/c again.
Not able to ride will be the worst!!!! I am modifying my bike to make it less difficult on my wrist. Brembo front brakes, malossi shocks, adjustable brake levers etc….
an interesting cross section of results. My surgery was November 6, 2013. I have been to the physiotherapist regularly since my cast was off. I have approximately 50% of the movement I had pre op. The grip strength was 110 pounds before the operation, and was 101 last week. There is no pain, which was the deciding factor for me. The exercises are crucial for recovery. I can get up from a prone position with the wrist bearing full weight. From my perspective it has been successful for me, although the lack of wrist movement takes a bit to get used to, however I don’t really even notice it anymore. If there was a potential chance for a ligament recovery I would do that first. My issue was the arthritis causing the pain.
I am on day 9, had my cast removed on day 5, had brace put on and started my exercises. Was back to work in four days, with restrictions of course. It was my right wrist and I am right handed so it isn’t easy, but neither was having the pain I suffered for about 15 years before someone figured out what the problem was. I had a block and day surgery. It lasted one hour and I was awake for the whole thing. I took T3s for the pain till the next morning and Tylenol for a day or so after. So far, so good. I’m seeing improvements every day and have started my exercises. Best thing that ever happened. As far as information goes, the surgeon, in Vancouver BC, was very helpful for the most part and I had none of the problems others apparently had. I was done with living in pain so this surgery was a god send.
That is wonderful news! 🙂 I hope the rest of your recovery is as good as the first 9-days…
Ken I had PRC on December 18 2013. The pain I had before the surgery is completely gone. I have almost no swelling and am using my hand and wrist with very little pain. I am very glad I had the surgery. I have my first physical therapy today. All my fingers work fine and each day they are getting stronger. I was able to return to work on January 2 2014 and use my hand and wrist everyday with some restrictions. I can move my wrist in both directions. My thumb is the weakest so far but is improving everyday. I am very happy I had the surgery and do not think it will be to long before I don’t notice much of a difference form pre-surgery. I believe the power of prayer has a lot to do with the healing to.
David, I also had my surgery in September 2013. Although I am not having the same issues you are, I am having issues. Specifically with the thumb of my PRC hand. Seems I have developed a form of tendonitis at the base of that thumb as a result of having the PRC surgery. I will find out in about 5 weeks if I will be needing a second surgery to relieve the pain from the tendonitis.. they call it Dequervane Syndrome. I think the surgery is similar to a carpal tunnel one only at the base of the thumb.
I have made good progress on my range of motion… just about half back both directions in just over 3 months. I still have considerably less strength in the hand but I squeeze play doh a few times a day… I find that easier and less painful than the medical putty I got from occupational therapy.
My surgeon told me it could take up to 18 months to fully recover from the surgery so some patients is a must. I still have swelling in the fingers but a good soak in the tub gets everything loosened up so I can get the hand and fingers moving to work some of the stiffness and swelling out.
I have just been released from hand therapy and was given the green light to begin taking my dogs back to training and shooting my hand guns again. I was told by both the surgeon and hand therapists the more I use it the faster it will come back and pain is my only limiting factor. I just hate the pain in my thumb from the tendons being compressed as its an almost constant pain.. almost as bad as before the surgery… certainly it’s just as limiting.
I had my surgery in the middle of May 2013. I still have pain. My doctor will not let me lift anymore than ten pounds. I have limited movement of my right wrist and I am right handed. I had swelling for a while so that doesnt surprise me about your hand. It will take time for the swelling to go away. I would have to suggest to move your fingers as much as possible.. I know it hurts but I did a lot of typing and I think that movement helped me. Hang in there 🙂
I had general anesthesia. I told him I did not want to be awake through it. They also did carpal tunnel surgery at the same time and removed a pain sensory nerve in the arm.
My name is Dave Mayes from Crawfordsville Indiana. I had the surgery in September of 2013. So far the only thing I think that is better than before the surgery is the pain I was having in my wrist. I am a mobile equipment Mechanic and it is necessary that I have strength and mobility in my hands to do my job. I still have very little strength in my right hand and it swells up daily. Since the surgery I have begun to have a lot of pain in my right shoulder. I cant raise my arm up to the side without extreme pain. When I put ice on my wrist to take the swelling down it hurts my shoulder so bad that I have to remove the ice from my wrist. I ask the doctor about this and he said he doesn’t know what would cause that. Blames it on another issue. So needless to say so far I am not really satisfied with the results of my surgery. I just pray it gets better.
Hi,
I know what you mean exactly. I have little to no pain but I am weak when doing certain things. My fingers and thumb is still stiff in the morning and will get stiff if I work them. I struggle with snow removal, cutting vegetables and so on. Question, Did you have a nerve block to freeze your arm for the surgery? I am trying to find some rhyme or reason to why some have success and others do not.
Hi Peter, in reading through the archives just now I want to give you my answer on the surgery which if you have been reading my posts is almost two years post op. My hand and fingers were so swollen for over a year. I had the nerve block. I insisted on the nerve block for two reasons; First and foremost, I live 5 hours south of Portland OR. I did not want to spend another night away from home so the nerve block was the fastest way to get out of the hospital and back on the long road home. My son drove so don’t worry, I was not about to be behind the wheel. The second reason I wanted the nerve block is because I also insisted on watching the entire operation. The nerve block was the only way I could do this and trust me, It was so fascinating and even though it took three solid days to “thaw out” from the block being able to witness them pulling the bones out of my hand was well worth it. I will get a nerve block on my next surgery too and this time I am going to insist they give me my bones removed should I get another PRC which I am not keen about. The doctor refused to give me my bones from my right hand PRC and I will not give into that again, even if I have to steal my own bones!
So do you think the length of time with nerve block vs general makes any difference? That could change my mind.
I had this surgery done in June it is now Nov. I can’t grip with my hand I can’t open a jar or even a pop can. I am right handed which is the hand that had the surgery. My problem is my thumb does not work right. I have little use of it. The dr. Is dumbfounded by it. My thumb was fine before surgery I dont know what to do now about my thumb. Any help would be appreciated!! Thanks!
Pam, I am not a doctor but I too have issues with my thumb. What exactly is your issue? Does it hurt at the base, stiff or swollen?
I had my right wrist done in 2006 and my left one done in 2010. i am very happy with the results. Now I can move both my wrist without all the pain I had before. I went through lots of therphy with both wrist and sure it was painful but it was better than having them fused and never moving them again. Mush easier wiping after going to the bathroom when your wrist bend. Again not as much when there where good but better than before surgery. i suffered for 4 years with my my right wrist before i had surgery but only 1 year with left wrist. I Pray is for anyone who has to go through this has as much luck as i did.
When you went through the therapy and it was painful, did it result in total swelling of your fingers and wrist each time?
I was in surgery for one and half hours also. My wrist will not move inward at all, moving up and down is a struggle and painful. My index finger has the most problems. I just came from therapy, they wanted me to use chinese balls (2) and move them in my hand.. that was impossible to do. That would be great if you can ask you doctors some questions. I dont get anywhere asking my questions to therapy and my doctor. It seems like they dance around the questions.
I was put to sleep for my surgery. Before surgery they gave me 2 pain pills and 2 valuim. When I woke up I was in a splint using an ace bandage. After 7 days the stitches were removed. The splint was on too tight. I did not loosen it at all, I fugured that the doctor put it on so I left it the way he put it on. I was in a cast for 3 weeks. Now I wear a brace and have therapy twice a week. I still have swelling and pain. My wrist does not move the way it once did.
My job… I work for a food service company that prepares food for college students. My doctor released me to work one handed, but this company will not let me return to work because I can not lift 50 lbs. I have applied for disablity and should find out soon if I qualify for benefits. I had my surgery in Erie, Pa. I also have arthritis in my hand. I am right handed and it is the right hand that had surgery. I dont know if they froze my arm or used a block during surgery. I dont get my questions answered by the doctor or by therapy. Why won’t they answer my questions? I feel like they will not tell me if I will have full use of my hand. Is it true that they do adjust the tendons for this surgery? I know they have to move them to get to the bones that are being removed. My surgery was a one day surgery. I had the surgery in the morning and was sent home a few hours after.
I do not know if they adjust tendons and such but I will ask my Doctor on Monday when I see them. My Doctor answers all of my questions however I often forget to ask the questions while I am there. This time I will have a few written down. My wrist and your wrist will never work the same as it was because they removed the three bones which contributed to 50% of the bending angle and made the complex joint workable .We now have a hinge that should bend maximum 50% of what your hand bend before . I am not in a brace anymore in my swelling goes down ever so slowly. My surgery was one hour and thirty minutes.
I also had my surgery in Erie, PA in October 2008. I had no luck finding out information about this surgery prior to my surgery on the internet. I had an accident with a fractured capitate bone and it wasn’t until a year and a half later that I had arthroscopic surgery only to find out I had completely torn ligaments and a significant amount of arthritis that led me to the PRC. I found the surgery to be very painful and slow healing. I returned to work two months post op. My job requires me to work on a computer for the better part of the day. I went thru PT and some cortisone injections over the next year. I found the pain was quite severe and I also was thinking of going for a disability retirement. Luckily I had a wonderful doctor that did not give up on me. In January of 2009 my doctor prescribed iontophoresis. I had never heard of this but I had this treatment done at the PT office. I had 2-3 treatments per week for a month and I can’t say enough good about the treatment. I am basically pain free now! I know when I have overused it but I also know my wrist will be fine if I give it some rest for the next day or so. My strength is pretty much back to what it was pre surgery days but of course the range of motion has limitations. My surgeon did a cut across my wrist so that the scar is basically hidden in the wrist creases. Being a female this was much appreciated! The biggest thing I cannot do is put pressure directly on the wrist area as you would do during a push up. It’s better to be pain free to me though!
I had a PRC done in may of this year. After surgery I was in so much pain I thought the pain would never end! My fingers were so swollen! I could not even hold a cotton ball!!! I had a cyst in a bone, the bone was factured, and the bone was dead. I still have swollen fingers and still have pain! I may never go back to my job because of this surgery.
I understand your frustration since I’m going to it myself. However, I have a friend who had fallen a year and a half ago in the United States and broke his wrist. He was traveling on vacation and had travel insurance. The hospital at Ocean City wanted to put him under while they said his wrist but the insurance refused to pay for the anesthesiologist and told him to drive back to Canada and have the wrist set in a Canadian hospital. Obviously he had chosen the wrong insurance company and this should be a lesson to most people who travel that the cheapest price isn’t always the best. But, when he came back to Canada they had to read fractured his wrist and set it properly and this required him to be in a cast for nine weeks. I met him last week at a shopping center and he explained that he had very similar problems with his fingers. In fact it was his left hand and he is a guitarist. He said after one year he can start playing guitar but not all the chords such as the “F” Chord. He said he went through many months of exercising his fingers and waking up every morning with them stiff. It seems like you’ve had your operation one or two months before me. My fingers are still swollen and if you look at day sixty-two entry you can see my progress at this point. I do have an ache in my fingers during the day but not really a pain that I cannot live with. I think it’s because of the swelling and once the swelling is down that aching will go away (at least I hope so). Where did you have your operation? How long did you have your cast on? Did they freeze your arm for the operation (Nerve Block) or did you have a general? What is your cast too tight? What is your job that you cannot go back to?
I agree and I am typing this with my fingers!! 🙂 My fingers are getting much better and now working on the wrist and thumb.
I am trying to decide whether to have the PRC. I tore 2 of the ligaments in my right hand some time back and didn’t realize it until it was to late to repair the ligaments. The bones are just sort of floating in my wrist. The doc says I will develop really bad arthritis If I don’t do this. It has been 2 years since he told me that and I am starting to get pain and loss of strength in that hand. I saw you were only in a cast for 2 weeks. I was told 6 to 8 weeks in a cast. Also, if you don’t mind my asking, why did you need the surgery and what were your symptoms?
Actually, my hand was in a half cast from June 19 two July 5 at which time the cast was removed and I was given a hand brace much similar to those you can buy at Walmart. From July 5 to July 12 I was to where to brace all of the time except for once daily to wash my hand and stitches. From July 12 two July 30 I was to wear the brace but could take it off to do my exercises and/or when I was just watching TV or sitting around doing nothing special that could injure my wrist. After July 30 I was only to where to brace if I was to do something strenuous or if my hand was in danger of being knocked such as out in public malls. I now wear the hand sock that went under the brace when I go out just to let people know that my hand is injured. You can read about my injury on my blog at the following link: https://proximalrowcarpectomy.com/how-it-came-to-be/. In my particular case I had no choice since I had cracked my lunate bone and the lunate bone was dry, brittle and in fact dead. They could not repair the lunate bone so the only option was to remove the row. I must’ve injured the lunate bone years ago and this had resulted in a lack of blood flow to the lunate bone which caused it to die slowly over time. Once the bone was cracked, my wrist was swollen, sore and would not move. It was much like being on death row with no option but to move forward to that room. The surgery was not elective, it was not my choice, it was the only option available to me. However, it was my choice to seek out the best surgeon available in Canada to perform the operation.
It is now just under two months and my fingers are still a bit swollen and I am working on getting the fingers, thumb and wrist to move. Because of my choice of operation in Toronto which was far away my physiotherapy only started today in my local town. I now plan to go to fuse you three times a week as I do my exercises five times a day. I am a bit disappointed that I cannot get on my motorcycle and ride this summer and I am not certain if I will be able to ride comfortably when this is all said and done.
In your case the bone seem to be floating. You should confirm that they are not getting blood flow and are in fact dead and/or beyond repair [brittle]. If they are getting blood flow there may be some options that a specialist could do. But hey, I am not a specialist, I’m not a Doctor and I shouldn’t even make these types of comments.
In conclusion, there is nothing to fear about the operation but the recovery is a lot of work and you will learn to hate your physiotherapist and the exercises they prescribed. I do not personally have any patience, I understand it’s a virtue not seldom found in men and I therefore expect to heal overnight. This is not the case and I have some days that are better than others were my fingers and wrist is more or less swollen. In fact I’m not typing this reply, I am using my Dragon software to dictate it. I thought I would be typing again by now.
Please keep checking back with my blog and please feel free to fill us in on what you decide to do and how it goes. Thank you for your response in your comments…
Philip, you don’t choose the PRC. The PRC chooses you. There is really nothing fair about it. And it is not something you can ‘hope’ away. I assume the issue is with your scaphoid and/or lunate bones. If they are indeed dead or dying, you realistically don’t have much choice in the matter. You don’t mention your age. If only the scaphoid is an issue, a 4 corner fusion might be an option. Based on what you have said, if you do nothing your wrist will become useless at some point due the the dead/dying bones breaking up. If you don’t do anything, you increase the chances of by passing the PRC altogether and going straight to a solid fused wrist. There really is not a whole lot of information on the internet in regards to actual people talking about their own experiences with PRC. Some of the little that I have read involves people ‘wondering if they should get a PRC’. Again, it’s really not something you choose. It chooses you.
My own experience, in a nut shell, is that one day I woke up with no indication of any potential left wrist problem. By the end of the day, my wrist felt mildly swollen and stiff for no apparent reason. After a couple months of steroids and NSAIDs, I had an MRI which showed a ligament missing from my scaphoid and only a portion of the bone was actually alive. I assume that the day my wrist first felt discomfort was the day the ligament came off the bone as a result of the bone being too dead to support it and the bone was no longer able to maintain the proper orientation in the wrist. I had the choice of 4 corner fusion or PRC. I chose PRC because the recovery is less involved and studies show that there really isn’t much difference in the end results. I had the surgery 1 July (4 months after first noticing discomfort in the wrist). I was in a cast until 18 July. Now I do daily range of motion exercises. I can’t do any lifting and such with the wrist because the new wrist structure has to reform it’s new pocket but I expect that in the next month or so I will be doing some strengthening exercises. I don’t expect to know for sure what I will have for a wrist for a couple more months. So far I have not had nearly the problems that Peter has had. I had functional use of my fingers within a day or two of the surgery. I only took pain pills for about two days after the surgery.
In summary, make sure you are talking to a hand surgeon. If there is a dead or dying bone in your wrist, I don’t think you have much of a choice in the matter.
Good Luck.
I had a PRC performed on November 6 of this year. The scars have healed very well, and the pain from the surgery was less than the pain caused by the arthritis in the joint. Therapy is ongoing. I was squeezing 110 lbs. pressure and am back to 60 lbs. after one week of physio. I am pleased so far with the progress, and will keep you informed.
After reading most of this blog, you all have my sympathy or perhaps empathy. I fell ≈4 feet to the ground in 2005 bending both of my hands back severely. The left wrist was magnificently sore for several months and then seemed to resolve itself. I fell on it again in 2008 and so I went to a hand surgeon for consultation. I was told that both hands would eventually suffer from SLAC and that the cure was worse than the injury. That isn’t necessarily so. The injury becomes quite painful after the ligaments have shredded themselves (10 years for the left, 12 years for the right) with the bones floating around and snagging on each other. I had a PRC on my left hand in 2015. 30 hours after the surgery and after calling the surgeons office, I received permission to “truncate” my cast and started playing mandolin as therapy. The reduction in flexibility of the left hand has necessitated a drastic change in playing style on the guitar so I play that a lot less and the bouzouki a lot more. Now, I’m facing another PRC on my right hand in less than 3 weeks and I know I have to go through all of this process yet again. This operation should be a tad easier than the left because there is no arthritis in the right hand. I should add that my surgeon cuts two nerves and denervates the hand reducing the amount of pain to a manageable level (24/7 dull ache). I have gotten to the point where I have to wear wrist braces at night to prevent bending my hands when sleeping. Failing to do so hurts more than I care to admit even though the braces are hot and uncomfortable.
So… here’s to the impending second PRC and the hopes that recovery will be successful. I wonder how many other musicians have ever gone through this malady.