Denervation surgery of the hand and wrist: A scoping review

To identify and summarize all primary studies addressing clinical results of patients undergoing denervation surgery for hand and wrist conditions.

We searched seven electronic databases, including MEDLINE (Ovid MEDLINE ALL, 1946 to present), Embase (OVID, 1974 to present), and the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library. We included any primary study addressing clinical outcomes of patients undergoing denervation surgery of the hand and wrist, regardless of their design or language. Two independent authors screened the studies. Three reviewers extracted the data, and two assessed the risk of bias using the MINORS score.

72 studies were included in this review, 65 already published, and seven ongoing studies. Most studies are of low level of evidence, and the majority (66 %) were performed in Europe. Forty-three studies (60 %) reported outcomes on wrist denervation surgery, 16 on first carpometacarpal denervation surgery, and nine on digit joints denervation.

Overall, hand and wrist denervation surgery seems to be a safe, pain-relieving, and motion-preserving treatment option for painful arthropathy. Nevertheless, surgeons must advise patients that revision surgery could be needed. High-quality, prospective, comparative studies are missing for wrist and hand denervation to provide strong evidence-based recommendations.