Wrist Surgery in NYC
Castle Connolly Top Doctors specializing in wrist surgery with 5,000+ hand and wrist procedures. Advanced arthroscopic techniques, expert fracture care, and complex reconstructions. From sports injuries to arthritis, we restore wrist function so you can get back to life.
Wrist Surgery at HSSI
Understanding Wrist Surgery
The wrist is one of the most complex joints in the human body—and one of the most frequently injured. Consisting of eight small carpal bones, numerous ligaments, the triangular fibrocartilage complex (TFCC), and the ends of the radius and ulna bones from the forearm, the wrist allows the remarkable range of motion we depend on for everything from typing to tennis.
When injury, arthritis, or other conditions affect the wrist, the impact on daily life can be profound. Simple tasks like opening a jar, turning a doorknob, or pushing yourself up from a chair become painful or impossible. Wrist problems can end athletic careers and prevent people from doing their jobs.
At HandSport Surgery Institute, our surgeons have performed thousands of wrist procedures—from minimally invasive arthroscopic repairs to complex reconstructions. We bring the specialized expertise needed to accurately diagnose wrist problems and provide the most effective treatment.
The Wrist’s Complex Anatomy
- 8 carpal bones in two rows form the wrist joint — scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate
- Numerous ligaments — including the critical scapholunate ligament, frequently injured
- TFCC — Triangular fibrocartilage complex acts as cushion and stabilizer on the ulnar side
- Radius & ulna — Distal radius is the most commonly fractured bone in the body
- 3 major nerves — Median, ulnar, and radial pass through or around the wrist
This complexity means wrist problems are frequently misdiagnosed. A “sprained wrist” may actually be a scaphoid fracture, ligament tear, or TFCC injury requiring specific treatment.
Wrist Conditions We Treat
HandSport Surgery Institute treats the full spectrum of wrist conditions, from acute injuries to chronic degenerative problems.
Wrist Fractures
Distal Radius Fractures
The most common wrist fracture, typically from falls on an outstretched hand (FOOSH). Treatment ranges from splinting or casting to surgical fixation depending on fracture pattern and displacement.
Scaphoid Fractures
Fractures of this critical carpal bone are often missed on initial X-rays. Delayed diagnosis can lead to non-union and avascular necrosis—serious complications requiring complex surgery. Scans may be helpful to define the injury.
Other Carpal Fractures
Fractures of the lunate, triquetrum, hamate, and other carpal bones, often occurring in combination with ligament injuries.
Distal Ulna Fractures
Often occurring with radius fractures or in isolation, affecting wrist stability and forearm rotation.
Ligament Injuries
Scapholunate Ligament Tears
Injury to the ligament connecting the scaphoid and lunate bones—one of the most important wrist ligaments. Untreated tears lead to progressive arthritis (SLAC wrist).
Lunotriquetral Ligament Tears
Tears between the lunate and triquetrum causing ulnar-sided wrist pain and instability.
TFCC Tears
Tears of the triangular fibrocartilage complex cause pain on the ulnar side of the wrist, especially with rotation. Common in racquet sports, gymnastics, and from falls.
Carpal Instability
When ligament injuries cause abnormal carpal bone alignment, leading to pain, weakness, and clicking.
Wrist Arthritis
SLAC Wrist
Scapholunate Advanced Collapse—progressive arthritis resulting from untreated scapholunate ligament injuries.
SNAC Wrist
Scaphoid Nonunion Advanced Collapse—arthritis from untreated scaphoid fractures that fail to heal.
Post-Traumatic Arthritis
Arthritis developing after wrist fractures or other injuries.
Rheumatoid Arthritis
Inflammatory arthritis affecting the wrist, often causing significant destruction if not managed appropriately.
Kienböck’s Disease
Avascular necrosis (death of bone due to poor blood supply) of the lunate bone, causing pain and progressive arthritis.
Tendon Problems
De Quervain’s Tenosynovitis
Inflammation of tendons on the thumb side of the wrist, causing pain with gripping and thumb movement. Common in new mothers.
Intersection Syndrome
Tendon inflammation on the back of the forearm near the wrist, often seen in rowers, weightlifters, and racquet sport athletes.
ECU Tendonitis/Subluxation
Problems with the extensor carpi ulnaris tendon and ligament on the ulnar side of the wrist, including inflammation and snapping.
Flexor Tendon Problems
Tendonitis or tenosynovitis affecting the flexor tendons as they cross the wrist.
Nerve Compression
Carpal Tunnel Syndrome: Compression of the median nerve at the wrist, causing numbness, tingling, and weakness in the hand. We’ve performed over 5,000 carpal tunnel releases. Learn more →
Guyon’s Canal Syndrome: Compression of the ulnar nerve at the wrist, causing hand weakness and numbness in the ring and small fingers. Often seen in cyclists and those using vibrating equipment.
Masses and Tumors
Ganglion Cysts: Fluid-filled sacs arising from the wrist joint or tendon sheaths—the most common wrist mass. Can cause pain and limit motion. Learn more →
Other Masses: Giant cell tumors, lipomas, and other benign or rarely malignant tumors requiring evaluation and treatment.
Types of Wrist Surgery
Our surgeons are expert in all modern wrist surgery techniques, selecting the optimal approach for each patient.
Wrist Arthroscopy (Minimally Invasive)
Minimally invasive technique using a small camera and specialized instruments through tiny incisions (portals) to diagnose and treat wrist problems with minimal disruption to surrounding tissues.
Conditions treated:
- TFCC tears — debridement or repair
- Scapholunate ligament injuries — debridement, thermal shrinkage, or repair
- Ganglion cyst excision
- Removal of loose bodies & cartilage injuries
- Synovectomy for inflammatory conditions
- Diagnostic arthroscopy & fracture reduction assistance
Benefits: small incisions (3–4mm each), less pain, faster recovery, direct visualization of structures not seen on imaging.
Fracture Fixation
When wrist fractures are displaced, unstable, or involve the joint surface, surgical fixation restores proper alignment and promotes healing. Modern techniques often enable earlier movement and faster return to function.
- Volar Plating: Standard for distal radius fractures—plate and screws applied through palm-side incision, often allowing early wrist movement
- Fragment-Specific Fixation: Specialized implants for individual fracture fragments in complex cases
- Headless Compression Screws: For scaphoid fractures—compress the fracture and bury within the bone accelerating healing
- External Fixation/Bridge Plates: For severely comminuted fractures
- Bone Grafting: Adding bone for fractures with bone loss or to promote healing of non-unions
Ligament Repair & Reconstruction
Wrist ligament injuries often require surgical treatment to prevent long-term instability and arthritis.
- Acute Ligament Repair: Direct repair when surgery is performed soon after injury (typically within 3–6 weeks)
- Ligament Reconstruction: Using tendon grafts when ligaments are too damaged to repair directly
- TFCC Repair: Arthroscopic or open repair depending on tear location and type
- Scapholunate Reconstruction: Complex procedures using tendon or synthetic grafts to restore this critical ligament
Wrist Arthritis Surgery
When arthritis destroys the wrist joint, several surgical options can relieve pain and restore function:
- Proximal Row Carpectomy: Removal of the scaphoid, lunate, and triquetrum bones, allowing the capitate to articulate with the radius. Preserves significant wrist motion and reduces pain.
- Partial Wrist Fusion: Fusing selected carpal bones (such as four-corner fusion) while preserving some wrist motion and reducing pain.
- Total Wrist Fusion: Fusing the entire wrist when other options aren’t suitable—eliminates pain but also eliminates wrist motion.
- Wrist Replacement (Arthroplasty): An artificial joint for select patients with rheumatoid or other inflammatory arthritis.
- Radial Styloidectomy: Removing a portion of the radius bone where it contacts the scaphoid—helpful for limited, focal arthritis.
Procedures for Specific Conditions
- Scaphoid Non-Union Surgery: Bone grafting and screw fixation for scaphoid fractures that haven’t healed, sometimes including vascularized bone grafts for complex cases.
- Ulnar Shortening Osteotomy: Shortening the ulna bone to treat ulnar impaction syndrome or TFCC problems related to positive ulnar variance.
- Darrach Procedure: Removing the distal ulna for select cases of DRUJ arthritis or instability.
- Sauvé-Kapandji Procedure: Fusing the distal radioulnar joint while creating a pseudarthrosis to preserve forearm rotation.
- Wrist Ganglion Excision: Removal of ganglion cysts, performed arthroscopically or through open incision depending on location and size.
The HandSport Surgery Institute Approach to Wrist Surgery
Accurate Diagnosis Is Everything
Wrist problems are among the most frequently misdiagnosed conditions in orthopedics. Patients are told they have a “sprain” when they actually have a scaphoid fracture, ligament tear, or TFCC injury. Our diagnostic approach is methodical and thorough.
Conservative Treatment When Appropriate
Many wrist conditions improve without surgery. Fractures may heal with casting, tendonitis responds to rest and therapy, some ligament injuries stabilize with immobilization. When we recommend surgery, it’s because we’ve determined conservative treatment won’t produce a good outcome.
Minimally Invasive When Possible
Our surgeons are leaders in arthroscopic and minimally invasive wrist surgery. When these techniques achieve equivalent or better results, we use them. However, we never compromise outcomes for smaller incisions.
Technical Excellence
Wrist surgery demands precision. The structures are small, the anatomy complex, and the margin for error minimal. Thousands of wrist procedures have developed our technical expertise for consistently excellent outcomes.
Comprehensive Follow-Through
Surgery is only part of treatment. Drs. Pruzansky personally supervise post-operative care, adjusting splints, monitoring healing, and directing therapy programs. Good surgery translates to good outcomes through hands-on follow-through.
What to Expect: Wrist Surgery at HSSI
Consultation and Diagnosis
Thorough review of symptoms: when they started, what makes them better or worse, how they affect activities. Dr. Pruzansky examines your wrist, testing range of motion, stability, and specific provocative maneuvers. On-site X-rays if needed. MRI or CT may be ordered. You’ll understand your diagnosis and treatment options by visit end.
Treatment Planning
For conditions that may improve without surgery, we start with casting, splinting, activity modification, therapy, or injections. When surgery is recommended, we explain the procedure in detail. Our staff handles insurance verification and authorization.
Surgery
Most wrist surgeries are outpatient at Surgicare of Manhattan and Manhattan Eye, Ear and Throat Hospital (part of Lenox Hill Hospital). Some complex surgeries at Lenox Hill and Mount Sinai. Anesthesia options include regional block, local with sedation, or general. Times vary from 30 minutes for simple arthroscopy to several hours for complex reconstructions.
Recovery and Rehabilitation
Post-operative care varies significantly by procedure. Follow-up visits to monitor healing, remove sutures, adjust or change splints/casts. Dr. Pruzansky personally supervises your recovery. Most wrist surgeries benefit from formal hand therapy.
Return to Activities
Our goal: restoring your wrist to full function—whether tennis, yoga, or working pain-free. We clear you based on objective healing and functional milestones. Sport-specific rehabilitation for athletes returning to competition.
Wrist Surgery Recovery: Detailed Timelines
Wrist Arthroscopy
Wrist Fractures
Ligament Surgery
Arthritis & Other
Factors Affecting Recovery
- Injury severity: More complex injuries require longer healing
- Time to treatment: Delayed treatment often means longer recovery
- Age and health: Younger, healthier patients typically heal faster
- Smoking: Significantly impairs bone and soft tissue healing
- Diabetes: Can slow healing and increase complication risk
- Compliance: Following instructions and attending therapy optimizes outcomes
Wrist Surgery Cost and Insurance
Insurance We Accept
- Aetna
- Blue Cross Blue Shield
- Cigna
- United Healthcare
- Medicare
- Oxford, Empire, Emblem Health
- Workers’ Compensation & No-Fault
- Many other commercial plans
Staff assists in verifying coverage before your appointment and handles prior authorization. Self-pay pricing available—call 212-249-8700.
What Determines the Cost?
- Surgeon’s fee: Professional fee for performing the surgery
- Facility fee: Hospital or surgery center charges
- Anesthesia fee: Anesthesia services
- Pre/post-op care: Consultations and follow-up beyond 3 months
For insured patients, out-of-pocket cost depends on your plan’s deductible, copay, and coinsurance structure. We also treat work-related wrist injuries under Workers’ Compensation and motor vehicle injuries under No-Fault insurance.
Why Choose HandSport Surgery Institute for Wrist Surgery?
Wrist Surgery Expertise
The wrist is our specialty. Unlike general orthopedic surgeons who see wrists occasionally, we treat wrist conditions every day. Thousands of wrist procedures translate to accurate diagnosis and superior technique.
Arthroscopic Specialists
Wrist arthroscopy requires specialized training and equipment. Many surgeons don’t offer it. Our extensive arthroscopic experience treats conditions through small incisions with generally faster recovery.
Castle Connolly Top Doctors
Both surgeons named Castle Connolly Top Doctors based on peer nomination. Dr. Mark Pruzansky ranks in the top 1.4% nationally with triple board certification.
Diagnostic Accuracy
Wrist problems are often misdiagnosed. Patients come to us after being told they have “sprains” when they actually have fractures, ligament tears, or other treatable conditions. Our thorough approach correctly defines the problem.
Personal Care
Dr. Pruzansky personally sees every patient, performs every procedure, and supervises every aspect of recovery. When you call with a question, you get answers from the doctor who knows your case.
Convenient Location
Park Avenue office with on-site digital X-ray and custom splint fabrication during your appointment. One location, complete care. Subway: 4/5/6 to 86th Street, 3-minute walk.
What Our Wrist Surgery Patients Say
"After months of wrist pain that other doctors couldn’t figure out, Dr. Pruzansky diagnosed a TFCC tear on my first visit. The arthroscopic repair was straightforward and I’m back to playing tennis without pain."
"I broke my wrist in a bike accident and was terrified I’d never have full use of my hand again. Dr. Pruzansky repaired the fracture beautifully. Three months later, I have full motion and strength."
"Dr. Pruzansky is the best doctor/orthopedist I’ve ever been to. He fixes issues that other doctors don’t even know how to diagnose and is with you every step of the way."
"After a scaphoid fracture that didn’t heal properly, I needed complex revision surgery. Dr. Pruzansky did the bone graft and screw fixation—six months later my wrist is pain-free."