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Proximal row carpectomy.

Edward Diao¹, Allen Andrews, McPherson Beall

¹Department of Orthopaedic Surgery, University of California San Francisco, 500 Parnassus Avenue, MU320W, San Francisco, CA 94143-0728, USA. diaoe@orthosurg.ucsf.edu

|November 9, 2005

Summary

Proximal row carpectomy is a valuable wrist reconstructive surgery for advanced arthritis, offering good longevity. Patients should be aware of potential secondary procedures for optimal outcomes.

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Area of Science:

Orthopedic Surgery
Hand Surgery
Wrist Reconstruction

Background:

Degenerative joint arthritis of the radiocarpal joint, including scapholunate advanced collapse (SLAC), scaphoid nonunion advanced collapse (SNAC), and Kienböck disease, presents significant challenges.
Traditional treatments may not fully restore function or alleviate pain in advanced stages.

Observation:

Proximal row carpectomy (PRC) is a reconstructive technique indicated for various debilitating wrist conditions.
The procedure can be augmented with dorsal capsule interposition, capitate excision, or radial styloidectomy.
Temporary Kirschner wire fixation may be employed during the surgery.

Findings:

PRC demonstrates good long-term efficacy for treating advanced radiocarpal joint arthritis.
Caution is advised for patients under 35 years old.
Secondary procedures, such as radial styloidectomy or capitate debridement, may be necessary for persistent pain or complications.

Implications:

PRC offers a viable reconstructive option for severe wrist arthritis, potentially delaying or avoiding more extensive surgeries.
Conversion to total wrist arthroplasty with implants is a future consideration for selected patients.
Patient education regarding potential secondary interventions is crucial for managing expectations and optimizing long-term results.

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