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Arthroscopic proximal row carpectomy.

Noah D Weiss1, Ricardo A Molina, Stephanie Gwin

  • 1San Francisco Orthopaedic Residency Program, St Mary's Medical Center, San Francisco, CA, USA. nweiss@weissortho.com

The Journal of Hand Surgery
|April 6, 2011
PubMed
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Arthroscopic proximal row carpectomy offers a safe and effective alternative for wrist conditions, enabling faster recovery. This minimally invasive technique demonstrates favorable outcomes in range of motion and grip strength compared to open surgery.

Area of Science:

  • Orthopedic Surgery
  • Minimally Invasive Procedures
  • Wrist Arthroscopy

Background:

  • Proximal row carpectomy (PRC) is a recognized treatment for various wrist pathologies.
  • Traditional PRC involves open surgery with dorsal capsulotomy.
  • Limited outcome data exists for arthroscopic PRC.

Purpose of the Study:

  • To present the technique and early outcomes of arthroscopic proximal row carpectomy (aPRC).
  • To evaluate the safety and efficacy of aPRC.
  • To compare aPRC outcomes with historical data from open procedures.

Main Methods:

  • Seventeen patients underwent aPRC using an arthroscopic bur.
  • Postoperative care included early range of motion exercises (2 days).
  • Outcomes assessed via range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and patient satisfaction questionnaires.

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Main Results:

  • 16 patients completed follow-up (average 24 months) with no complications or conversions to open surgery.
  • Average wrist flexion-extension was 80% and grip strength 81% of the contralateral side.
  • Mean DASH score was 21; 100% patient satisfaction; 13/16 returned to previous employment with mild/no pain.

Conclusions:

  • Arthroscopic proximal row carpectomy (aPRC) is a safe, effective, and reliable option for wrist conditions.
  • aPRC facilitates quicker patient mobilization compared to open surgery.
  • Functional outcomes (range of motion, grip strength) are comparable to open PRC.