London: In what could be called a major breakthrough, British doctors claim to have carried out on a 41-year-old man the world's first wrist replacement surgery that preserves natural wrist movement.

A team, led by Greg Packer of Spire Wellesley and Southend University Hospital, carried out the pioneering surgery on Tim Ablethorpe, an insurance manager from Essex.

In fact, the doctors gave him a hemi-wrist arthroplasty -- a half-wrist replacement that involves inserting an implant into the wrist to replicate the workings of particular bones and restore mobility, the mail reported.

The prosthetic, being developed in collaboration with US experts, is a milestone in the treatment of wrist injuries in younger patients, say the doctors.

It is designed to recreate the "dart-thrower's motion" -- a simple gesture  that encompasses most of the  wrist movement we take for granted, but is one that patients who have had a full replacement lose for ever.

Previously, only two treatments were available -- a total wrist replacement with metal implants attached to the end of the arm and to the hand, separated by a spacer to allow hand movements, or having the bones of his wrist fused together. Both result in limited mobility.

According to Packer, the limitations of the full wrist replacement are highlighted by its poor uptake. "Almost all activities require wrist movement, from brushing your teeth to playing a round of golf. While you can function with a fused wrist, it is a big compromise," he said.

Prime candidates for this new procedure are younger patients suffering from scapholunate advanced collapse in the wrist, who until now have had to settle for their bones being fused into immobility.

This common condition develops over a long time after damage to the main ligament of the wrist -- from a sports injury, for example. It results in the scaphoid bone, on the thumb side of the wrist, separating from the other bones of the wrist.

Patients with fractures of the scaphoid or fractures affecting the surface of the wrist joint will also benefit from the new operation, say the doctors.

The new implant gives a recovery time of weeks rather than months. A total wrist replacement needs replacing within five to 10 years, while the implant made of cobalt chrome lasts 20 years.

The new operation involves removing three bones in the lower wrist -- the scaphoid, lunate and pisiform – and inserting the canine-tooth-shaped implant in place of the scaphoid, say the surgeons.

They make a hole in the radius, one of two major bones in the forearm, and tap the narrower end of the implant into place. The broader end remains unfixed, allowing the other wrist bones to move normally around it.

Tim was 19 when he fractured his scaphoid playing rugby. He was left with limited movement, which worsened over the years. The main stabilising ligament of the wrist had been damaged, allowing the bones to separate.

(Agencies)