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Wrist Four Corner Wrist Fusion

@rdgallo Welcome back to BoneSmart! Sorry you are hurting post op. Sounds darn frustrating. Is physio helping you at all?

You will notice I moved your latest post to your original thread here. Having all your information in one place will help us in case we need to advise you.

You might want to bookmark this thread.

Please let us know how your appointment goes on Monday.
 
Just a quick update. I have seen the doctor a couple times since the last post. Pain is still really bad. CT scan taken on May 3 shows only minimal fusion. The plate and screws have not loosened. The doctor put me back on the bone stimulator. I am using it 20 min. per day on the top side of the wrist and 20 min. per day on the bottom side of the wrist. He also told me to put the wrist splint back on. It has been a year and a half since the first botched surgery and I have as much or more pain than I did before the first surgery. I will see the doc again in another 6 weeks.
 
@rdgallo So sorry you are still having issues with this fusion! Fingers crossed the bone stimulator helps.

Did your surgeon have a plan if things don't improve in 6 weeks. Sounds like a pretty short space of time.
 
The doc didn't mention what the next steps would be. I haven't found anything on the internet that gives any info for a next step either. I hope the stimulator works, but don't have a lot of faith in it. I used it for almost 6 months after the failed/botched 4 corner surgery and it did nothing. I also used it for about a month after the total fusion surgery and it did nothing significant. I wish I had not had either surgery. The good news is my right wrist (dominant hand) that is really bad with arthritis won't go through any surgeries due to what I have learned from my left wrist surgeries. I am so happy I did my left wrist first.
 
More bad news. I saw my doc again on 8/23/21 to go over a new CTscan. The scan and xrays show that one of the screws holding my plate in place has broken. The head of it separated from the rest of the screw which allowed movement of the plate. The scan also showed little fusion. I am now scheduled to have the hardware removed and replaced on Dec 7. The doc said he would also use a product called Ignite to aid in fusion.
 
I am heartbroken for you. As someone who went through a partial then a total wrist fusion, I can relate to an extent. I can't imagine the pain you must be feeling.

Has this been the same surgeon all along? Would it be possible to go get a second opinion and go see someone else all together?

I also have a history of fractures not healing well. I had a humerus fracture, wrist fracture and a pelvic osteotomy that they tried to fuse that also did not fuse. All 3 of those all required repeat surgeries because I had non-unions in all 3 cases. Each of my fractures had to be dealt with a bit different(the stimulator was also suggested to me), but hip bone graft was used in 2 of the fracture sites to stimulate the bones to heal together, and repositioning the bones and placing new hardware is what promoted the healing of the third.

Having been there and having also had a surgeon tell me to just keep waiting for things to heal, I ended up telling him to shove it and I got another opinion who fixed me up. If this is the same surgeon who's just made you wait, perhaps it's time to consider getting another orthopod.
 
@rdgallo .... I'm so sorry that the full fusion failed. Did the surgeon indicate why the screw might have broken? In following your story, it certainly didn't seem like you were overdoing things with your wrist during all this time. How very frustrating this must be for you. I know hand surgery can be quite complex. Have you considered getting yet another consultation?
 
I am sorry it has been so long since I last posted. I never receive a notification when someone comments on my post. I do appreciate the responses. To answer the question of me seeing another doc for a second opinion...no, I have not. The doc that tried to revise the failed partial fusion attempt of another doctor did my total fusion last December. He does not really know why the screw head broke off and guessed it might be the result of movement allowed by the lack of fusion. He said because the Scaphoid has already been removed, he only has about 40% of the normal bone surface to fuse to the Radius bone. Next Tuesday, Dec 7, he will remove all of the hardware he put in during the last surgery and use a product called "Ignite" mixed with cadaver bone. He will pack this in between the areas that need to fuse and then put a new plate and screws in to hold everything in place. He said he would keep me in a short arm cast for 3 months and restrict me to absolutely no use of the hand/wrist for 6 months. He said he would also have me back using the bone stimulator. I have confidence in this doctor. He has been a hand surgeon in our area for over 21 years and has a very good reputation. So, I will post again on here sometime after Dec. 7 to let you know how things are going. Again, I appreciate all the reponses from all of you. Have a Merry Christmas!
 
rdgallo said:
I am sorry it has been so long since I last posted. I never receive a notification when someone comments on my post. I do appreciate the responses. To answer the question of me seeing another doc for a second opinion...no, I have not. The doc that tried to revise the failed partial fusion attempt of another doctor did my total fusion last December. He does not really know why the screw head broke off and guessed it might be the result of movement allowed by the lack of fusion. He said because the Scaphoid has already been removed, he only has about 40% of the normal bone surface to fuse to the Radius bone. Next Tuesday, Dec 7, he will remove all of the hardware he put in during the last surgery and use a product called "Ignite" mixed with cadaver bone. He will pack this in between the areas that need to fuse and then put a new plate and screws in to hold everything in place. He said he would keep me in a short arm cast for 3 months and restrict me to absolutely no use of the hand/wrist for 6 months. He said he would also have me back using the bone stimulator. I have confidence in this doctor. He has been a hand surgeon in our area for over 21 years and has a very good reputation. So, I will post again on here sometime after Dec. 7 to let you know how things are going. Again, I appreciate all the reponses from all of you. Have a Merry Christmas!
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That’s great news! As long as you feel confident in your doc, that’s what counts. It’s when you really second guess their work, that you run

I know how much relief my complete fusion has given me, and can only wish you the best with this new attempt.

keep us posted :)
 
@rdgallo Sounds like you found a very good surgeon. It's so important that we trust those trying to resolve these complicated situations. Please do keep us updated! All the best on the 7th!
 
This sounds like a good plan and I agree your surgeon sounds like someone to stick with. Obviously yours is a more difficult case than the norm and you want someone with ideas and experience. Sounds like your doctor has both. I'll look forward to your next update.

I modified your account preferences so you should receive email when someone posts in your thread or one you're watching. Hopefully that will help you.
 
Thanks, Jamie. I thought I had my account set up for email notifications, but apparently I didn't. I appreciate you fixing it for me. I will report back sometime after the 7th.
 
Sometimes the notifications go to your "junk" or "spam" folders, so always be sure to check there for notices.
 
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That's quite the bruising around your waist and a bandage. What was done there since your surgery was on your wrist?

The fusion itself looks good. How are you doing?
 
That bruising is the result of the bone graft harvest from the hip Iliac crest. I believe he harvested a 2cm x 2cm tricortical bone graft. So far, that has been the most painful part of the surgery. I am hurting but otherwise fine.
 
I just finished reading your thread.. you've really had a rough time of it with your wrist. Wishing you a complete recovery and fusion this time and hope you continue to update on your progress.
 
Wow @rdgallo impressive bruising. That poor hurt paw! Hope the hip area pain is easing. Have you tried icing the area?
 
Jaycey, I have been icing the paw, and alternating ice and heat on hip/side area. The pain is intense. Hopefully it will all settle down soon.
 
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