Proximal row carpectomy with a dorsal capsule interposition flap

Arthritis of the wrist can be a debilitating condition that presents with progressive pain and loss of motion. A proximal row carpectomy (PRC) is indicated for the management of wrist arthritis and is designed to improve pain while maintaining motion. It involves excision of the scaphoid, lunate, and triquetrum with the formation of a new articulation between the base of the capitate and the lunate fossa of the distal radius. The PRC is a technically straightforward procedure that can produce reliable results. It is contraindicated in cases with midcarpal arthritis and degeneration of the base of the capitate. In addition, there is a question of durability of the new articulation between the capitate and the lunate fossa of the distal radius. The use of interposition tissue can potentially decrease joint contact pressures and improve long-term durability. A PRC technique with the use of an interposition flap based on the dorsal capsule of the distal radius is presented.