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Proximal row carpectomy for scapholunate dissociation.

J C Elfar¹, P J Stern

¹University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA. openelfar@gmail.com

The Journal of Hand Surgery, European Volume

|September 3, 2010

Summary

Proximal row carpectomy for static scapholunate dissociation leads to a stiff, weak wrist with reduced function. Many patients experience persistent pain and cannot return to manual labor jobs.

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Area of Science:

Orthopedic Surgery
Hand Surgery
Wrist Biomechanics

Background:

Static scapholunate dissociation is a common wrist instability.
Proximal row carpectomy (PRC) is a surgical option for this condition.
Outcomes of PRC for static scapholunate dissociation require further evaluation.

Purpose of the Study:

To evaluate the radiographic and clinical outcomes of PRC in patients with static scapholunate dissociation.
To assess wrist range of motion, grip strength, pain levels, and patient satisfaction post-PRC.
To compare outcomes with historical data for other scapholunate dissociation treatments.

Main Methods:

Retrospective review of 31 patients undergoing PRC for static scapholunate dissociation.
Assessment of postoperative wrist range of motion and grip strength.

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Evaluation of pain severity, medication use, and return to work status.

Main Results:

Mean postoperative flexion/extension was 74°, significantly less than the uninvolved side (137°).
Mean grip strength was 22 kg, compared to 39 kg on the uninvolved side.
Fifteen patients reported moderate/severe pain, four required wrist arthrodesis; nearly half of manual laborers did not return to work.

Conclusions:

PRC for static scapholunate dissociation results in a stiffened and weakened wrist.
Patients undergoing PRC for this indication experience poorer functional outcomes and return-to-work rates compared to other treatments.
PRC may not be the optimal treatment for static scapholunate dissociation when considering long-term function and patient satisfaction.