Neurectomy

There are a number of conditions that can cause chronic wrist pain including osteoarthritis, scapho-lunate advanced collapse SLAC, scaphoid non-union advanced collapse and Keinbock's disease. In many instances the patient presents at a late stage of the condition which means that repair or reconstruction may not be possible. One of the operations that may be an option is called a neurectomy. There are a number of nerves that supply the sensation to the wrist but there happen to be two which exclusively end in the wrist. In other words the nerves do not go any further into the hand. These two nerves supply a variable amount of the sensation coming from the wrist. This means that if they are cut then there should be relief of pain without affecting the function of the hand in any way at all. Studies have shown this to be an effective procedure (Weinstein and Berger).

It is a simple operation performed as a day case usually under an arm block. Immediately after surgery a sling is recommended for the first day. The bandage can be removed to a simple dressing on the third day. Sensible light activity is advised until the wound has healed usually by the tenth day. The true effect of the procedure is not always instantly apparent and it may take a couple of weeks before the benefit is recognised.