Daily Mail

Wrist op stopped my pain – and gave me my job back

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AROUND 1.6 million people in the UK have osteoarthr­itis in the hand or wrist. Nick Busuttil, 43, a builder and father of two from Southampto­n, underwent a new procedure for it, as he tells ADRIAN MONTI.

THE PATIENT

AT THE start of 2015 I noticed a lump on the inside of my right wrist. It felt quite hard and grew over the next two months to about the size of half a golf ball. It started to make my job difficult as I couldn’t move my wrist properly, and the joint became painful, with a sharp stabbing pain whenever I tried to use tools. even picking up a cup of tea became a struggle.

In february 2015 I saw my GP who said it could be inflammati­on and told me to take ibuprofen and use ice. These didn’t help, so a few weeks later I was referred to Southampto­n NHS Treatment Centre.

The pain was now so bad it felt like someone was sticking pins into my wrist when I tried to move it.

An X-ray showed I had advanced osteoarthr­itis — the cartilage between my bones had completely worn away, so bone was rubbing on bone. The swelling was actually a cyst on one of the bones, which was probably genetic.

My partner Lorraine and I were worried about whether I’d be able to work for much longer.

The convention­al treatment was a partial fusion where they’d remove the bone causing the problems and fuse the remaining small bones together so the ends don’t rub. But the cyst had weakened one of the bones in my wrist so it might shatter if they used the convention­al screws and metal plates.

The only other option was a full fusion, which would severely restrict my wrist movement.

Then my surgeon said he could fuse the bones using ‘staples’ — I’d keep a lot of movement and the weakened bone wouldn’t be affected.

I had the two-hour surgery in June 2015 under general anaestheti­c. Afterwards my wrist was in a sling but I wasn’t in pain. I left hospital the next day and wore a cast for six weeks. In March last year I had the same op on my left wrist. FIFTEEN

months since my second operation, both of my wrists are pain-free and I can do almost everything I could before. I avoid using drills but otherwise I am fine.

If I hadn’t had this op, I would have had to find a new career. I can play with my ten-year-old son Reagan and enjoy life again.

THE SURGEON

Vasileios Kefalas is a consultant hand surgeon at southampto­n NHs Treatment Centre. He says: ARTHRITIS in the wrist is fairly common. But Nick had it in both wrists, which is quite rare and could have been genetic and made worse by his type of heavy work.

Painkiller­s and steroid injections can ease it. But when it gets worse, patients need surgery.

This can be either a partial fusion — when a bone is removed and others are fused together — or a full fusion, where we insert a metal plate to connect the forearm bone to the wrist. This leaves patients with very little wrist movement.

for the past few years I’ve been using ‘memory’ staples to perform a type of partial wrist fusion. It has better results than using metal plates as I can choose where I put each staple to fit the patient, allowing greater mobility.

Metal plates can be bulky and impede union between bones. The staple technique means patients such as Nick could avoid a full fusion. The memory staples — which are 12-17 mm long — are made from a metal alloy (nickel and titanium) and change shape at different temperatur­es. Once in the body, the warmth makes the staples’ legs close and locks them into place.

I make an incision in the wrist and remove the scaphoid bone. Then I locate the bones I need to fuse together and drill a 2mm hole in each side: I use one staple to connect two bones, placing one end of each into the holes to connect them. The ends fold in as the staple warms up and this creates a strong union between the two bones. for Nick, I scraped the cyst away, too.

Normally patients wear a cast for two weeks before using a splint and starting physiother­apy. Because of the cyst, I kept Nick’s wrist in a cast for six weeks. This is still a quicker recovery than cases using screws, which can take up to eight weeks.

The results have been very encouragin­g and other surgeons could easily be trained. There have been no failures or instances where bones don’t fuse; there’s a 10-20 per cent failure rate when using screws, wires and plates.

Memory staples are very strong and could be used for other types of wrist fusion and arthritis in other parts of the body. As it gives patients more mobility, it can be a useful way of helping those with advanced osteoarthr­itis in the wrist and it is my go-to choice. THE operation costs around £2,000.

 ??  ?? Mobile: Builder Nick Busuttil, 43
Mobile: Builder Nick Busuttil, 43

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