Wrist Surgery — Procedure Guide, Recovery & Risks | MyMedicPlus

Wrist surgery encompasses multiple procedures addressing distinct pathologies: carpal tunnel release (CTR) for median nerve compression, volar locking plate ORIF for distal radius fractures, TFCC repair for ulnar-sided wrist instability, wrist arthroscopy, scaphoid fixation, and wrist fusion (arthrodesis) for end-stage arthritis.

Carpal tunnel release is indicated for confirmed median nerve compression on nerve conduction studies with failed conservative management. Distal radius ORIF treats displaced or unstable fractures. TFCC repair addresses wrist instability or ulnar-sided pain from ligamentous injury unresponsive to 6 weeks of conservative care.

Carpal tunnel release: open (3cm incision) or endoscopic (1–2 small portals) division of the transverse carpal ligament under local anaesthesia (15–20 min). Distal radius ORIF: volar plating via Henry approach under regional or general anaesthesia. Wrist arthroscopy: 2.7mm scope through 3–4 small portals for TFCC debridement or repair.

Carpal tunnel release: light hand use at 2 weeks; full activities at 4–6 weeks. Distal radius ORIF: volar splint for 2 weeks; physiotherapy begins at 6 weeks; return to heavy work at 3–4 months. Occupational therapy and hand therapy are key components of wrist rehabilitation after all procedures.

Carpal tunnel release risks: nerve or tendon injury, pillar pain (radial and ulnar heel of palm), scar hypersensitivity, and symptom recurrence (1–5%). ORIF risks: extensor pollicis longus (EPL) tendon rupture, complex regional pain syndrome (CRPS), hardware-related complications, and malunion if inadequate fixation.

Carpal tunnel release achieves greater than 90% patient satisfaction with resolution of nocturnal paraesthesia. Volar locking plate ORIF achieves good or excellent functional outcomes in over 90% of distal radius fractures. Wrist arthroscopy for TFCC repair provides pain relief and improved function in 70–85% of patients.