Proximal row carpectomy for scapholunate dissociation.

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.
• 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.