1983...The Shoulder Bone is Connected to the Wrist Bone...

Growing up in Connecticut, we always hit the slopes at Big Bear (now known as Thunder Ridge Ski Area) just across the state line in New York.  As most middle-school boys do, there were always people (aka girls!) to show off for.  Unfortunately for me, an over-the-head tumble on one of the Black Diamonds trail in 1983 landed me in the lodge and at the doctor's office on the following Monday.  

This was before the wide-use of MRI for tendon/ligament imaging, but the X-Ray was normal, probably just a sprain.  In a splint for a few weeks and move on with life.  

Fast forward a few years (2020) and taking a fall during a trail run (Shoulder separation)- chapter two of my wrist problem re-emerges.  

Then Act 3- chopping wood in March of 2023 is when I really wrenched my wrist sent me over the edge in pain and swelling.  Urgent care- X-Rays, once again, were negative, only a splint for a few weeks and move on with life (Sound familiar?)

This time, however, it was recommended to follow up with my PCP and possibly an Orthopedic hand/wrist specialist.  

So, June 2023, I started down the journey of trying to avoid surgery.  Multiple steroid injections,  wrist Occupational Therapy, and more splinting.  When all that was futile, we finally MRI, X-Rays, and wrist fluoroscopy in January 2024.  

The wrist fluoroscopy was pretty cool- under the scope, the Orthopedist could move the wrist and see how the joint and ligaments moved together- or didn't!  The pain corresponded to where the underlying problems were. She was able to diagnose that I had a few torn ligaments (Scapho-lunate ligament) an ulna that was too long and grinding against the Triquetrum and Lunate. 

Bottom Line- over the years the Triangular Fibrocartilage Complex (TFCC) was torn and worn around the edges:  starting way back in 1983 and the final tear caused the final tear and problems today.

My X-Ray showing the Ulna much longer than the Radius- causing the tear and pain

There are two diagnoses that I had:  Ulnar Impaction Syndrome and an Unstable Distal Radial-Ulna Joint.  

SOLUTION:  two-step approach:  

    1.  Arthroscopy of the wrist joint to actually see what is going on and clean up the tears and stitch the             TFCC back where it belongs.

    2. Shorten the Ulna so it is level with the radius so that it won't tear the TFCC again and realign with             the other wrist-bones.

Before the Ulnar Shortening

After Ulna Shortening

This is the plate- about 4 inches long.

This surgery was a tough one.  Not only is it my dominant arm/hand, the 4 in plate and nine screws will alter how I work and get back to various activities.  Recovery will be long - 8 weeks in a splint and cast, then a splint throughout my therapy to regain strength and flexibility.

The short-arm cast I'll be in for six weeks.

Hopefully my appointment on January 27th, 2025 will get the cast off, and into a removable splint.  I'll start Occupational Therapy at that time and get back to a normal routine!  This is all dependent on bone healing at the osteotomy site:

You can see where the orthopedic surgeon cut the (diagonal line) bone with a screw across the gap.  This dark line (hopefully) will fill in as the bone grows back together.  He removed 4 mm of bone to shorten the ulna.

Keeping my fingers crossed that all goes well over the next few weeks.