I don’t know that I can explain it well, but my daughter’s wrist is fused. By the time she was diagnosed, it would no longer bend. She got some range back from time to time, but nothing lasted.

My understanding is that it is caused by damage to the bones, not just inflammation. When someone chooses to have surgery to fuse a joint, my understanding is that it is because moving it is too painful. I’ve heard of people also getting ankle fusion.

Pain in daily activities was never a problem for my daughter; she just adapted to whatever range she had (and the wrist is on her dominant hand – she only switched once temporarily after a steroid injection).

She has slept in a night splint for more than eight years, to keep her wrist from turning down. The goal is to keep it in the most functional position. You can see this for yourself: Make a fist with your wrist straight, then compare the strength to a fist you make with your wrist bent.

We have heard tons of conflicting information over the years from different doctors and OTs. Rheum – she needs PT. PT – she needs OT. Rheum – she needs to wear the splint all the time. OT – she needs to be using her wrist as much as possible, only sleep in it. Rheum – get right back to OT after injections. OT – we are taught to protect the joints. Rheum – if you don’t do XYZ, she will need her wrist fused. OT – her wrist is fused.

One day, her wrist did move at OT. I saw her eyes get wide. I will never forget her face at that moment. Ever. We thought it was a breakthrough, improvement. I was told to keep aggressively stretching her at home. I did.

Then I noticed her wrist looked different and felt different and wouldn’t stretch the same. At the next OT appointment, we were sent straight to xray. She had a wrist subluxation.

That movement was just her wrist coming apart. There is nothing they can do. No more OT, either. The surgeon said it was just going to go where nature wanted it, and if we didn’t like where it ended up, he would put it somewhere else one day, but not any time soon.

After that, she had a few weeks while it decided what to do. No range for a few days, then she’d bump it on the couch and it would flop over and she’d have lots of range. Pain for a day or two when it was in a bad place. Eventually it settled in, and isn’t painful anymore but she has no real range of motion. The last time a rheum tested her grip strength, both hands were equal and NORMAL, which had never happened before the subluxation, so that is a very bright spot in this dark story! She functions so well that she does not qualify for school OT services, but I have been able to have them evaluate her quarterly through her 504 plan.