CPT® Code 25805

1. Indications

The procedure of wrist arthrodesis with a sliding graft is indicated for several specific conditions and symptoms that necessitate surgical intervention to alleviate pain and restore function. The following are the primary indications for this procedure:

• Severe Wrist Pain resulting from degenerative joint diseases such as osteoarthritis or rheumatoid arthritis, where conservative treatments have not provided adequate relief.
• Wrist Instability due to previous injuries or trauma that have compromised the structural integrity of the wrist joint.
• Failed Conservative Treatments including physical therapy, medication, or splinting, which have not successfully managed the symptoms or improved the patient's quality of life.
• Post-Traumatic Arthritis that develops after a wrist fracture or other significant injury, leading to chronic pain and dysfunction.

2. Procedure

The procedure for wrist arthrodesis with a sliding graft involves several critical steps to ensure successful fusion of the wrist joint. The following outlines the procedural steps:

• Step 1: Incision The surgeon begins by making a precise incision over the wrist area, which allows for direct access to the underlying bone structures. This incision is carefully planned to minimize damage to surrounding tissues and facilitate optimal healing.
• Step 2: Dissection After the incision is made, the surgeon dissects through the layers of tissue to reach the wrist joint. This step requires careful handling of the soft tissues to avoid complications and ensure that the joint is adequately exposed for the procedure.
• Step 3: Graft Preparation Once the wrist joint is exposed, the surgeon prepares a sliding graft from the surrounding bone. This graft is essential for immobilizing the joint and promoting fusion. The graft is shaped and sized appropriately to fit into the joint space.
• Step 4: Graft Placement The prepared sliding graft is then positioned within the wrist joint to block movement. This placement is critical, as it must be secured in a manner that allows for proper healing and fusion of the bones over time.
• Step 5: Closure After the graft is in place, the surgeon carefully closes the incision. This involves suturing the layers of tissue back together to promote healing and minimize scarring.

3. Post-Procedure

Following the wrist arthrodesis with a sliding graft, patients can expect a recovery period that may involve immobilization of the wrist in a splint or cast to ensure that the graft remains stable and the bones fuse properly. Pain management strategies will be implemented to address any discomfort during the healing process. Physical therapy may be recommended after an initial healing period to help restore function and strength to the wrist. Regular follow-up appointments will be necessary to monitor the healing progress and ensure that the fusion is occurring as expected. Patients should be advised on activity restrictions during the recovery phase to prevent complications and promote optimal outcomes.