In simple words: This procedure involves surgically removing the hand at the wrist joint. The surgeon makes incisions to create skin flaps from the palm and back of the hand. These flaps are used to cover the surgical area after the hand is removed. The surgeon carefully separates the hand bones from the forearm bones at the wrist joint. The blood vessels and nerves are addressed, and then the skin flaps are stitched together to close the wound.

This procedure involves surgically separating the hand from the forearm at the wrist joint. A long palmar flap is preferred due to the thick and pressure-adapted skin of the palm. An incision is made just below the radial styloid process, extending to the ulnar styloid process. This flap, including palmar fascia and parts of the thenar and hypothenar muscles, is raised. A dorsal flap is created with an incision on the back of the hand. Blood vessels are ligated, and muscles and nerves retracted. Disarticulation proceeds from the ulnar to the radial side, cutting circumferentially around the joint. The styloid processes are rounded off, and the wound is closed by suturing the flaps in layers, packed with antiseptic gauze.

Example 1: A patient presents with a severely mangled hand following a traumatic industrial accident. Due to irreparable damage to nerves, vessels, and soft tissues, the decision is made to perform a disarticulation through the wrist., A patient with a chronic, non-healing infection in the hand, unresponsive to all other treatments, undergoes disarticulation through the wrist to prevent further spread of infection., A patient with a locally advanced malignant tumor of the hand, not amenable to limb-sparing surgery or other treatments, undergoes disarticulation through the wrist.

Documentation should include the reason for disarticulation, the condition of the hand and wrist, pre-operative evaluation, operative details including technique and findings, and post-operative plan.