Denervation of the hand and wrist: A systematic review

With an aging population and the increasing prevalence of arthritic pathologies of the hand and wrist, denervation is one therapeutic option for hand surgeons. In case of pain but preserved motion, denervation is a treatment of choice. We conducted a systematic review of the literature, searching the MEDLINE, LILACS, SciELO and PubMed databases for cohorts reported in the last 20 years on denervation of the wrist and trapeziometacarpal, metacarpophalangeal and interphalangeal joints with a focus on postoperative outcomes, selecting 25 articles. The 1187 patients were divided into 3 groups: wrist denervation (999 patients), trapeziometacarpal denervation (124 patients), and metacarpophalangeal and interphalangeal denervation (64 patients). Improvements were found for pain (55.73%, 86%, 85%, respectively), range of motion (11.8%, 4°, 17°) and satisfaction (80.67%, 87.5%, 81.8%). Grip strength increased in wrist and trapeziometacarpal denervation (31.04% and 23%). The results suggest that denervation can be an alternative to arthroplasty or arthrodesis for painful wrist and hand joints, without precluding subsequent procedures if necessary.