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Published on: May 23, 2025
Hand replantation with proximal row carpectomy.
Sang-Hyun Woo1, Young-Keun Lee, Hang-Ho Lee
1Woo & Lee's Institute for Hand Surgery and Reconstructive Microsurgery, W Hospital, 101-6 Gamsam-Dong, Dalseo-Gu, Daegu 704-902, South Korea. handwoo@hotmail.com
Hand (New York, N.Y.)
|October 16, 2008
Summary
Proximal row carpectomy aids hand replantation after wrist amputation, preserving wrist motion. This technique, used in five industrial trauma cases, yielded functional results and prevented arthritis.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Trauma Surgery
Background:
- Complete hand amputations at the wrist level present significant reconstructive challenges.
- Preserving wrist joint function post-replantation is crucial for overall hand utility.
Purpose of the Study:
- To detail the operative technique for hand replantation combined with proximal row carpectomy.
- To evaluate the postoperative functional and radiological outcomes of this combined procedure.
Main Methods:
- Five patients with complete hand amputation underwent replantation with proximal row carpectomy and transarticular fixation.
- Functional outcomes (muscle strength, range of motion, sensation) were assessed using Chen's criteria.
- Radiological evaluation assessed radio-capitate joint space and arthritic changes.
Main Results:
- All five cases achieved Grade II results according to Chen's criteria.
- Mean grip and pinch strength were 41% and 45% of the contralateral hand, respectively.
- Postoperative CT scans showed preserved radio-capitate joint space without arthritic changes.
Conclusions:
- Proximal row carpectomy is a valuable adjunct in selected hand replantation cases at the radiocarpal or midcarpal level.
- This technique can effectively preserve wrist joint motion and prevent degenerative changes post-replantation.
