What an Operation!

WARNING: THIS POST INCLUDES SOME MEDICAL INFORMATION AND PHOTOS BUT NOTHING TOO GRUESOME.

22 February 2025: Update - The 'Big Op' is now booked for 20 March 2025.

By late 2024, I had seen a plethora of medical professionals about the issues I was having with my wrist. None of them had fixed the problem - or even properly identified what the problem was. After some wrangling with my medical insurance provider, I booked in to see a new consultant in October 2024. After another MRI scan, this consultant was more confident that he knew what the problem was. Apparently the big bone in my forearm - the ulnar - was rubbing into the bones in my wrist. He was sure that this was what was causing the pain.

The Lesser of 2 Evils?

He offered two options: a more invasive procedure with a higher success rate, or keyhole surgery, which was less invasive but also less likely to fix the problem. The keyhole surgery was to ‘clean it up a bit’, have look at what was actually going on in there and to see if anything simple could be done to fix it.

The big op was something called an ulnar shortening osteopathy - basically your forearm gets shortened so that it doesn’t rub into your wrist so much. But they don’t just shave a bit off the end - that would be too easy! The procedure involves - in layman's terms - taking a thin slice out of the middle of the ulnar, like a slice out of the middle of a banana, pulling the ulnar back away from the wrist and fixing it in the new position with a plate and screws. The diagram below shows what they do with 'before' on the left and 'after' on the right.

Choices!

The idea of the more invasive surgery wasn’t exactly appealing – it sounded pretty serious.  Ideally I only wanted to go through surgery once but if there was a chance of an easy win with the keyhole surgery and a quicker recovery, I felt I should start there. Who would want a slice taken out of their forearm if they didn’t have to?

So I decided to start with the keyhole surgery. I figured it was worth a shot, and if it didn't work, I could always go back for the more invasive procedure. 

Ready for the keyhole surgery!

Under the Knife

The surgery itself went smoothly, but when I woke up, my wrist was swollen and stiff and hidden by a massive bandage. It looked like a big, white loofah. The surgeon explained that he'd found some damaged cartilage (grade 4) and a tear in the TFCC (a small complex area made up of ligaments, tendons and cartilage which helps support and stabilize your wrist). 

The 'Loofah'

He said it was worse than he had been expecting and that he had drilled some tiny holes into ‘lunate’ (one of the bones in the wrist) to try to stimulate healing of the cartilage. He had also ‘debrided’ the TFCC, meaning clearing out the damaged tissue from the area, again so it could have a chance to heal properly. Lastly, he had done a ‘denervation’ - you can probably guess what this means. This was intended to reduce the pain that I would feel in the area. To be honest, this is what I remember him saying although I was still coming round from the general anesthetic so don’t quote me.

Two weeks later, I had the bandage off and this is what it looked like...

The bandages come off 2 weeks post-surgery

The 3 puncture wounds were the 'keyhole(s)' bit and the longer one was for the denervation.

It was a touch choice whether to just go for the big op or try the smaller one and hope that it worked. Spolier alert: it didn't! But even in retrospect, I think I would probably have made the same choice again.

I'd love to hear what you think. Have you been in a similar position? What did you do?