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After surgery

After Wrist Arthroscopy

What to expect after minimally invasive wrist surgery, including TFCC debridement, synovectomy, and diagnostic arthroscopy. The instructions below apply to arthroscopy alone; if a larger repair was performed you will have additional instructions.

What was done

A small camera (an arthroscope) was placed inside the wrist through two or three small puncture incisions on the back of the wrist. Inflamed lining tissue, a torn edge of cartilage, or a frayed edge of the TFCC (triangular fibrocartilage complex) was addressed through other tiny instruments placed the same way. You have several small incisions — each about 3 to 5 mm — covered with a light dressing, and the wrist is usually in a soft wrist brace.

The first 5 days

  • Keep the dressing on, clean, and dry.
  • Keep the hand elevated above the level of your heart as much as possible. This is the single most helpful thing for swelling and pain.
  • Move the fingers often — full finger motion from day one prevents stiffness.
  • You may use the hand for light daily activities (eating, dressing, typing a phone) in the brace.
  • Ice over the dressing for 20 minutes at a time helps with swelling.
  • No lifting more than 5 pounds with the operated hand for the first 2 weeks.

Day 5: dressing comes off

  • Remove the dressing 5 days after surgery. You can shower and wash over the small puncture sites with soap and water. Pat dry.
  • Cover each small incision with a simple adhesive bandage for a few more days, or leave them open once they are dry and closed.
  • No soaking (baths, pools, hot tubs) for 2 weeks.
  • The wrist brace continues to be used for comfort and for any protective restrictions discussed at surgery.

Pain and expected symptoms

  • Most patients take only over-the-counter pain medicine (Tylenol and ibuprofen) for the first few days. Prescription pain medicine, if prescribed, is usually only needed briefly.
  • A "puffy" feeling of the back of the wrist and hand in the first 1 to 2 weeks is normal.
  • Pain relief from the procedure may be noticeable within weeks, or may take up to 3 months to reach its peak as the joint settles.
  • Bruising along the back of the forearm from fluid that was pumped into the joint during the arthroscopy is common. It fades in a week or two.

Activity

  • Driving: when you can make a comfortable fist, have full finger motion, and feel safe with the brace on — usually 3 to 7 days.
  • Typing / desk work: right away in the brace, in moderation.
  • Return to light work: usually within 1 week.
  • Return to heavy manual work: 4 to 6 weeks.
  • Hand therapy: not routinely needed after simple arthroscopy. If stiffness or weakness is slow to resolve, we will arrange a short course.
  • Sports: low-impact (running, cycling) from 2 to 3 weeks; contact or impact sports from 6 weeks.

Follow-up

Come to the office 10 to 14 days after surgery for a wound check. Follow-up again at 6 weeks.

Call the office right away if
  • You have a fever over 101°F
  • Any of the puncture sites is draining pus, is spreading red, or is very warm
  • Pain is worsening instead of improving after the first few days
  • You have new numbness, weakness, or severe swelling in the hand

Related

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