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Modified volar approach for proximal row carpectomy.

Raffaele Mugnai1, Filippo Pantaleoni2, Marta Montanari2

  • 1Department of Orthopaedic Surgery, University of Modena and Reggio Emilia, Policlinico di Modena, Largo del Pozzo 71, Modena, 41125, Italy.

Journal of Hand and Microsurgery
|September 5, 2024
PubMed
Summary
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A modified volar approach for proximal row carpectomy improves wrist function and range of motion. This technique offers better access for complex wrist conditions and simultaneous carpal tunnel release.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Wrist Biomechanics

Background:

  • Proximal row carpectomy (PRC) is a standard treatment for wrist pathologies.
  • Traditionally performed via a dorsal approach, it can lead to limitations.
  • A volar approach offers potential advantages, including concomitant procedures.

Purpose of the Study:

  • To describe a modified volar approach for proximal row carpectomy (PRC).
  • To evaluate the efficacy of this modified volar PRC technique.
  • To compare outcomes with the traditional dorsal approach.

Main Methods:

  • Retrospective analysis of 38 patients undergoing modified volar PRC (1992-2015).
  • Detailed description of the modified volar surgical technique, including skin incision, capsular section, and bone removal sequence.
Keywords:
Proximal row carpectomySLACSNACVolar approachWrist osteoarthritis

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  • Assessment of patient outcomes using Mayo Wrist score and range of motion.

    • Main Results:

    • Significant postoperative improvement in Mayo Wrist score.
    • Enhanced total active range of motion post-surgery.
    • Outcomes comparable to those reported for dorsal PRC.

    Conclusions:

    • The modified volar approach provides excellent access to proximal carpal bones.
    • It is particularly beneficial for complex cases like chronic perilunate dislocations.
    • This technique is recommended for patients requiring simultaneous carpal tunnel release or addressing extensor tendon issues.