"The surgical treatment of the arthritic and deformed wrist joint used to involve fusing the wrist joint into one solid bone," he said. "Although this treatment is effective in relieving wrist pain associated with arthritis, the disadvantage of joint fusion was the loss of motion across the wrist, which restricts the full use of the wrist."

An orthopedic company, Kinetikos Medical, Azzo said, recently developed an artificial wrist joint which has been successfully implanted in 83 patients in the United States in the past year.

Dr. Azzo became familiar with this artificial joint at a meeting of the American Academy of Orthopedic Surgeons in New Orleans. "It was clear that this implant represented a revolutionary improvement in artificial wrist joints because of its great stability, range of motion, and the minimal invasive bone cuts it required," he said.

Mrs. Geneva Trump, of Shady Spring, was one of the patients Dr. Azzo operated on last Friday. Arthritis had ruined her right hand, not only taking away its strength and usefulness, but also turning her hand into a source of never-ending suffering.

"I was in constant pain all the time," Trump said.

The advanced arthritic deformity of her hand meant she could no longer drive. "I could do nothing with my hand. My fingers were so crooked, I had no grip at all. I couldn't straighten my fingers. I had to give up my driving because I couldn't turn the key in the ignition."

Over the past three years, the progress of the arthritis meant further disablement. "I couldn't eat with my hand because I couldn't hold a fork. I couldn't lift a cup of coffee. I couldn't do anything with it."

Losing the use of her right hand was troubling, but it was the pain that drove her to undergo wrist-replacement surgery. "I told my husband I just could not tolerate the pain anymore."

Tuesday she was in Dr. Azzo's office, having the bandages and cast removed temporarily so the doctor could examine her progress. Four days after the surgery, she could begin to straighten her fingers and move them without pain. As Dr. Azzo examined the stitches, Trump said, "This doctor has been a miracle for me. He gave me hope I could have a working hand again. I am so pleased just thinking about having my hand back, it's hard to even say."

As she moved and straightened her fingers, the meaning of the successful surgery was revealed in her face. It lit up. "It's like a miracle. It makes me feel proud to know I'm going to have a hand I can use."

Dr. Azzo said arthritis of the wrist is quite common and is caused by degenerative joint disease (osteoarthritis), chronic inflammatory condition (rheumatoid arthritis) or traumatic arthritis.

"In addition to the symptoms of joint pain, swelling, and stiffness, there is the debilitating deformity that usually results from rheumatoid arthritis. Once the deformity develops in the wrist joint, it is usually followed by mechanical weakness in the hand and other deformities start to develop in the rest of the hand, especially in the joints at the base of the fingers."

"The treatment of the painful arthritic and deformed wrist is complex because the surgeon has to recommend a procedure that is tailored to the severity of the affected joint and the patient's job demands and activities. While some patients may prefer strength and power, others require motion."

For more information about artificial joint replacement of the wrist, contact Dr. Azzo (304)324-2725. Websites include www.OrthoDoc.a-aos.org/azzo, American Academy of Orthopedic Surgery at www.aaos.org., or Kinetikos Medical Incorporated at www.visitkmi.com.

- Contact Dennis Yena at dyena@bdtonline.com