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Proximal row carpectomy.

Peter J Stern1, Steven S Agabegi, Thomas R Kiefhaber

  • 1Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, P.O. Box 670212, Cincinnati, OH 45267-0212, USA. sternpj@ucmail.uc.edu

The Journal of Bone and Joint Surgery. American Volume
|September 6, 2005
PubMed
Summary
This summary is machine-generated.

Proximal row carpectomy offers good long-term results for wrist arthritis in patients over 35. Younger patients may experience higher failure rates, necessitating caution with this motion-sparing procedure.

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Wrist Arthroscopy

Background:

  • Proximal row carpectomy is a recognized motion-sparing surgery for wrist degenerative conditions.
  • Limited data exists on the long-term clinical and radiographic outcomes of this procedure.

Purpose of the Study:

  • To evaluate the long-term functional and radiographic results of proximal row carpectomy.
  • To identify factors influencing the success of proximal row carpectomy.

Main Methods:

  • Twenty-two wrists (21 patients) underwent proximal row carpectomy for degenerative arthritis (1980-1992).
  • Long-term follow-up (average 14 years) assessed objective and subjective function.
  • Radiographic evaluation of joint space was performed.

Main Results:

  • 18% failure rate (4 wrists) requiring fusion, all in patients ≤35 years old (p=0.03).
  • Successful cases showed average 72° motion, 91% grip strength, and high patient satisfaction.
  • Radiographs showed radiocapitate joint space loss in 14/17 wrists, but this did not correlate with functional outcomes.

Conclusions:

  • Patients over 35 achieved satisfactory motion, strength, and pain relief with proximal row carpectomy.
  • Caution is advised for performing proximal row carpectomy in patients younger than 35.
  • Radiographic joint degeneration does not necessarily predict poor clinical outcomes after proximal row carpectomy.