Wrist denervation

What is wrist denervation?

Surgical denervation of the wrist is a useful palliative procedure for chronic wrist pain when reconstructive procedures are not feasible or desirable.

Wrist denervation aims to stop nerves that are transmitting pain such as the anterior and posterior interosseous nerves (near the wrist joint) and the articular branches of the superficial radial nerve. The procedure can allow for long-lasting pain relief and better function of the wrist.

Which conditions might require wrist denervation?

Degenerative arthritis is a condition that leads to the painful limitations of wrist motion and indicates that wrist denervation is necessary.

Other indicators include scaphoid nonunion, painful carpal instability, ligament injury and Kienbock’s disease.

What is the surgical procedure used during wrist denervation?

Wilhelm’s wrist denervation is a surgical procedure used to cut tiny branches of the sensory nerves to the wrist and hand. Cutting these nerve pathways means that pain signals to the brain can be stopped. The motor nerves are not disturbed so there is no loss of motion or strength.

The operation takes around 45 minutes and involves four small incisions on both the front and back of the wrist and hand. The incisions are closed with wire sutures and a dorsal plaster splint is applied. 

Following surgery, grip, strength, wrist motion and pain improves.