Wrist osteoarthritis

definition

Osteoarthritis is the wear and tear of the cartilage between joint structures. It can also affect the wrist and have a variety of causes. The most common form on the wrist is saddle joint arthrosis (rhizarthrosis).
The arthrosis of the wrist is also called Radiocarpal arthrosis designates and describes a degenerative change of Wrist.
The osteoarthritis of the wrist is compared to other joint changes very rare, however, leads with massive expression to a very severe functional restriction up to complete loss of function of the wrist.
As a rule, women are more likely to suffer from wrist osteoarthritis.

Classification

There are basically two different forms of wrist osteoarthritis:

• Idiopathic / primary wrist osteoarthritis
  Primary radiocarpal arthrosis is a Self disease of the joint Roger that.
  It comes to one genetic inferiority of the articular cartilagewhose cause is unknown.
• Symptomatic / secondary wrist osteoarthritis
  The secondary wrist osteoarthritis, however, occurs after previous illnesses on. Typical for this are Fractions (Fractures), permanent Incorrect loads, one Rheumatoid arthritis or innate Malformations of the joint (congenital dislocation).

root cause

There are different causes of wrist osteoarthritis:

1. Some Patients are prone to degenerative joint changes and can develop wrist osteoarthritis without an explainable cause.
2. In other cases, osteoarthritis is caused by massive overloads,
3. post-traumatic or
4. flammable.
5. Especially Scaphoid fractures or Broken spokes can later cause osteoarthritis.
6. In rarer cases there are previous Torn ligament of the wrist The cause of wrist osteoarthritis.

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My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
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In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
I don't want to join the ranks of "quick knife pullers".
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Symptoms

The remodeling of the bone leads to:

• Pain,
• swelling and
• Restrictions on movement of the hand.
• In addition, after a while Joint deformities become visible.

As a rule, the pain is particularly pronounced at the beginning during exercise, but over time there is also pain at rest.
Furthermore can relapsing joint inflammation occur due to the remodeling processes. These go with Swelling, redness and warmth of the affected wrist. Wrist osteoarthritis can occur on just one hand or on both sides.
Although wrist arthrosis is comparatively rare, it does lead to one in the course of the disease massive restriction of mobility. If the osteoarthritis is not stopped in its progression, the function of the wrist can be completely lost.

diagnosis

The diagnosis of wrist osteoarthritis is primarily made with a conventional x-ray in two levels. Here are one in particular Joint space narrowing and a subchondral sclerosis recognizable. The formation of cystic destruction can also be recognized in the X-ray image. In the case of acute, activated osteoarthritis, the wrist also shows clinical abnormalities:

• overheat,
• diffuse Soft tissue swelling,
• Redness and
• appropriate Pain when moving or at rest.
• Also the agility of the wrist is in some cases degraded.

therapy

The therapy of wrist osteoarthritis should initially conservative respectively. A surgery is considered last resort.

The following Therapy Paths is there:

• Treatment of wrist osteoarthritis should initially be conventional. Such therapy includes physiotherapy with cold applications, physiotherapy or electrical stimulation. In order to avoid further overloading of the joint, a supportive and movement-limiting cuff (orthosis) can be adapted. This also relieves the pain because it does wrist supports.
• If these measures are not sufficient, long-acting pain relievers or anti-inflammatory drugs can be injected directly into the joint space. These can both alleviate the pain in the joint and inhibit the inflammation process and thereby slow down the progression of the disease.
• In acute pain conditions, pain medication can also be taken orally and thus systemically effective in order to make the acute pain more bearable. However, this should only be done after Consultation with a doctor be taken regularly and permanently.
• If these measures are not yet sufficient, the nerve itself can be numbed, which means that pain can no longer be passed on.
• If the pain is permanently too severe, a pain catheter can be placed in the immediate vicinity of the nerve supplying it for a certain period of time (10 to 14 days). This is advanced to the affected area via a small catheter so that no incision is necessary. A small dose can be continuously applied via this catheter Local anesthetics be injected.
  Since the nerves supplying the blood vessels are also numbed, the blood flow in the affected area is increased significantly. This particularly counteracts the pain caused by inflammation.
• However, if the conservative therapeutic measures do not provide satisfactory relief from the symptoms, wrist osteoarthritis can occur operational be treated. There are various ways of doing this. For one, during a Arthroscopy the cartilaginous disc between Cubit (Ulna) and spoke (Radius) can be corrected in order to enable the joint surfaces to slide smoothly again.
• In addition, muscle tissue can be transplanted into the joint and thereby replace the articular cartilage.
• If these options are not available, the wrist can be completely replaced by an artificial joint. The interruption of the nerves that supply the wrist with sensitive pain fibers (denervation) was increasingly abandoned. The reason for this is today's very successful stiffening (arthrodesis) of the wrist. The joint is completely removed and the bone ends are screwed together firmly.
  Though loses his wrist agility, but because of the subsequent Freedom from pain the hand can then be used much better again.

surgery

A surgical treatment of wrist osteoarthritis always aims to relieve the patient of the discomfort and especially to maintain the mobility of the affected joints.
An operation for osteoarthritis in the wrist usually always comes as last chance in question. It is particularly indicated when the disease has progressed to such an extent that it restricts everyday life and especially movement. There are also unbearable ones Wrist painwhich can also be alleviated by surgery.

There are different methods in question:

• As part of a Denervation (Nerve conduction disorder) If the transmission of pain can be interrupted, the pain caused by osteoarthritis will be reduced.
  This measure is a huge relief for many patients.
• The Partial stiffening (Partial arthrodesis) of a section of the wrist, if the osteoarthritis does not yet affect all wrist bones. A residual mobility remains, which still enables the daily activities of the hand. Complete stiffening (Arthrodesis) is possible on the wrist. The fingers remain mobile.
  However, this procedure should be considered last as the operation is no longer reversible.
• If the wrist has been severely damaged by osteoarthritis, it is Implantation of a prosthesis very useful. Despite the implant, the hand can develop its full strength and can be stressed accordingly. The mobility is also largely retained after a short period of getting used to it and then offers the patient a significant improvement and even freedom from symptoms.

In general, wrist surgery should be considered very carefully. In addition, the choice of procedure depends on the age of the person affected and the severity of the disease.

Exercises for osteoarthritis of the wrist

Osteoarthritis is a progressive disease that is particularly associated with a progressive (advancing) Deterioration of the affected joints.
It is all the more important that the joints are moved regularly in order to prevent the restriction of movement from progressing. This often poses a particular challenge for the patient, as the disease can also be painful and intermittent.

If operations have already been carried out and joints have been replaced by prostheses, for example on the wrist, it is all the more important that the remaining joints and fingers are kept active with exercises.
A can be helpful for such exercises small rubber ball or a so-called water lily. The fingers are passed through holes and the patient repeatedly closes his fist against a slight resistance. In this way the fingers remain very flexible and the muscles are trained. Small rubber balls have the same effect.
A tennis ball can also be used for daily exercises. For example, it can be grasped with the fingertips of both hands. Now the hand is moved in the wrist and fingers like when opening and closing a can. This exercise is also particularly suitable for exercising the wrist.

Another exercise for the hand is to circle two smaller balls around each other in one hand. It promotes the mobility of the fingers and strengthens the muscles of the entire hand. Regular, multiple repetition exercises can slow osteoarthritis and prevent more severe wear and tear on the joint surfaces.

Taping for osteoarthritis

In the early stages of osteoarthritis, but also with progressive restriction of movement due to the disease, conservative measures such as the Kinesio tape often relieve the pain and support the muscles.
This relieves the joints. As a result, the pain is relieved and the wear and tear on the joint surfaces is also reduced.

The tape strips can first be attached by a trained doctor or a physiotherapist. Once you have finally learned the technique, you can tap your wrist yourself. It is important that the tape is correctly seated and that it is pulled sufficiently so that it can achieve its effects.
The tapes are often attached lengthways to the back of the hand and on the inside above the wrist up to about the middle of the forearm. This is followed by a circular strip around the wrist.
Various techniques can be used for attachment. Which is most suitable and possibly also most bearable for the patient can be worked out and applied in consultation with the doctor or the physiotherapist.

Summary

Arthrosis of the wrist is a rare but very restrictive degeneration of the wrist. She goes with strong Pain, massive restricted mobility, Redness, swelling and inflammation hand in hand. Both hands can be affected at the same time in some cases.
The causes are very different and some of the wrist arthrosis cannot be traced back to a causal disease. The wrist arthrosis goes with both typical clinical complaints, as well as with classic radiological signs and can be easily recognized using clinical and imaging diagnostics.
The therapy can initially conservative and relieve the symptoms very well for some time.
However, if the symptoms do not decrease enough, there is a possibility of one surgery. Above all, the Stiffening of the wrist (Arthrodesis) has taken on a high priority, as it brings back both freedom from pain and hand function to a certain extent.