A BRITISH man has become the first patient in the world to benefit from a new form of wrist replacement that preserves natural wrist movement. Tim Ablethorpe, an insurance manager from Southend-on-Sea, Essex, was given a hemi-wrist arthroplasty a half-wrist replacement earlier this year. The procedure involves inserting an implant into the wrist to replicate the workings of particular bones and restore mobility. British surgeons have worked with US developers on the prosthetic, which is being hailed as a breakthrough in the treatment of wrist injuries in younger patients. It is designed to recreate the 'dart-throwers 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. MO 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 Greg Packer, of Spire Wellesley and Southend University Hospital, who carried out the pioneering procedure in March, the limitations of the full wrist replacement are highlighted by its poor uptake. Fewer than one in ten of the 4,000 patients who could benefit from this surgery opt for it every year. Packer says: '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. Prime candidates for this new procedure are younger patients suffering from scapholunate advanced collapse (SLAC) 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. It is not suitable for those with advanced or inflammatory arthritis, which often affects the whole wrist and still requires a total replacement. MO