During my hand fellowship I once asked my program director Al Hess MD why he had become a hand surgeon after completing his training in orthopaedic surgery. His answer was “In the other stuff I had become so perfect that it was boring”.
Wrist surgery is a prime example why hand surgery is never boring, let alone anybody will ever become perfect at it. Biomechanics and kinematics are incompletely understood at best, which renders restoration of an unknown “normal” an impossible task. The success rates of joint replacement of all or part of the wrist lag light years behind the almost uniformly good outcome in hips or knees. Correlating pain relief with surgical manoeuvers continues to be enigmatic.
Below is a potpourri of some of the most difficult wrists my personal collection:
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