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Proximal row carpectomy with partial capitate resection

G D Salomon1, R G Eaton

  • 1Department of Orthopedic Surgery, St. Luke's/Roosevelt Hospital Center, New York, NY 10019, USA.

The Journal of Hand Surgery
|January 1, 1996
PubMed
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Proximal row carpectomy with capitate resection offers pain relief and improved wrist function for degenerative arthritis and trauma. This surgical technique shows promising intermediate-term results, even with lunocapitate or radiolunate disease.

Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Wrist Arthroscopy

Background:

  • Degenerative arthritis of the wrist, including scapholunate advanced collapse and chronic scaphoid nonunion, presents significant challenges.
  • Lunocapitate and radiolunate degenerative diseases often complicate treatment decisions for proximal carpectomy.
  • Acute complex radiocarpal trauma requires effective surgical management to restore function.

Purpose of the Study:

  • To evaluate the intermediate-term outcomes of proximal row carpectomy with partial capitate resection.
  • To assess the efficacy of this modified technique in patients with degenerative wrist conditions and acute trauma.
  • To determine if lunocapitate and radiolunate disease contraindicate this surgical approach.

Main Methods:

  • A review of twelve patients who underwent proximal row carpectomy with partial capitate resection.

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  • Ten patients had degenerative arthritis (scapholunate advanced collapse or scaphoid nonunion) with varying degrees of lunocapitate and radiolunate involvement.
  • Two patients underwent the procedure for acute complex radiocarpal trauma.
  • Main Results:

    • At a mean of 55 months follow-up, 75% of patients reported no pain, and 25% experienced occasional pain with strenuous activity.
    • A trend towards increased total active flexion/extension arc was observed (80 to 94 degrees), with a significant improvement in flexion (p = .01).
    • Grip strength significantly improved from 19 to 26 kg (p = .01), and patients with dorsal capsule interposition achieved an average arc of 111 degrees.

    Conclusions:

    • Proximal row carpectomy with partial capitate resection demonstrates favorable intermediate-term results for pain and function in degenerative wrist conditions.
    • The technique may improve radiocarpal mechanics by redistributing compression forces and potentially enhancing the radiocarpal interface with dorsal capsule interposition.
    • Lunocapitate and radiolunate degenerative disease should not be considered absolute contraindications for a modified proximal row carpectomy.