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Proximal row carpectomy: a multicenter study

R W Culp¹, F X McGuigan, M A Turner

¹Department of Orthopaedic Surgery, Naval Hospital, Oakland, Calif.

The Journal of Hand Surgery

|January 1, 1993

Summary

Proximal row carpectomy improved grip strength and patient satisfaction in nonrheumatoid arthritis patients. However, the procedure was ineffective for rheumatoid arthritis patients and yielded poorer outcomes with advanced preoperative arthritis.

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Area of Science:

Orthopedic Surgery
Hand Surgery
Wrist Arthroscopy

Background:

Proximal row carpectomy (PRC) is a surgical procedure for wrist pain.
Evaluating outcomes of PRC is crucial for patient selection and surgical planning.

Purpose of the Study:

To assess the clinical outcomes of proximal row carpectomy.
To identify factors influencing the success of PRC.

Main Methods:

Retrospective evaluation of twenty patients undergoing PRC.
Assessment of pain, motion, grip strength, and functional activity.
Radiographic analysis of preoperative and postoperative x-ray changes.

Main Results:

Nonrheumatoid arthritis patients showed a 15% decrease in motion and a 22% improvement in grip strength.

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82% of nonrheumatoid arthritis patients reported improved conditions and would repeat the procedure.

PRC failed in all three rheumatoid arthritis patients.

Mild preoperative arthritis correlated with better outcomes than advanced disease.

Conclusions:

Proximal row carpectomy is effective for nonrheumatoid arthritis patients with mild preoperative changes.
PRC is not recommended for patients with rheumatoid arthritis or advanced degenerative changes.
Patient-reported improvement and willingness to repeat the procedure indicate satisfaction in suitable candidates.