Proximal row carpectomy in advanced Kienbock's disease.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Wrist Arthropathy

Background:

• Kienbock's disease is a condition affecting the lunate bone in the wrist.
• Advanced stages often lead to significant pain and functional limitation.
• Surgical interventions aim to preserve or restore wrist function.

Purpose of the Study:

• To evaluate the clinical outcomes of proximal carpal row resection arthroplasty in patients with advanced Kienbock's disease.
• To assess pain levels, grip strength, wrist mobility, and patient-reported outcomes.
• To identify potential complications associated with the procedure.

Main Methods:

• Retrospective clinical review of 21 patients with advanced Kienbock's disease.
• Patients underwent resection of the proximal carpal row.
• Follow-up included clinical assessment, grip strength measurement, and validated questionnaires (DASH, PRWS).

Main Results:

• Mean follow-up was 67 months.
• 13 patients reported no or mild pain; 3 reported moderate pain; 5 reported severe pain.
• Grip strength increased from 19 kg to 26 kg (65% of contralateral side).
• Slight improvement in wrist mobility was observed.
• Mean DASH score was 22; mean PRWS was 30.
• Two patients developed Complex Regional Pain Syndrome; one had a superficial wound infection.

Conclusions:

• Proximal carpal row resection arthroplasty is a viable surgical option for advanced Kienbock's disease.
• The procedure demonstrates satisfactory functional recovery and pain reduction.
• Potential complications such as CRPS and infection should be considered.