Functional results after proximal row carpectomy to salvage a wrist

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Thomas Kremer - , Heidelberg University  (Author)
  • Michael Sauerbier - , University Hospital Frankfurt (Author)
  • Markus Traenkle - , Heidelberg University  (Author)
  • Adrian Dragu - , University Center for Orthopedics, Trauma and Plastic Surgery, Heidelberg University , Dept Hand Plast & Reconstruct Surg (Author)
  • Guenter Germann - , Heidelberg University  (Author)
  • Steffen Baumeister - , Heidelberg University  (Author)

Abstract

Proximal row carpectomy is a movement-preserving procedure in the treatment of arthrosis of the wrist. We have retrospectively assessed the objective and subjective functional results after proximal row carpectomy. Assessment of outcome included measurement of range of movement (ROM), grip strength and self-assessment of pain relief with a visual analogue scale (VAS) and the Disabilities of arm, shoulder, and hand (DASH) questionnaire. Results were graded using the Mayo and Krimmer wrist scores. Fourty-five patients (mean age 48 (30-67) years) were evaluated with a follow-up of 32 (8-115) months. Underlying conditions included: degenerative arthritis secondary to scapholunate advanced collapse deformity, or chronic scaphoid non-union (n=35), Kienbock disease stage III (n=4), chronic perilunate dislocation and fracture-dislocation (n=4), avascular necrosis of the scaphoid (n=1), and severe radiocarpal arthrosis secondary to distal radial fracture (n=1). Active ROM for wrist extension and flexion was 70 and mean radial and ulnar deviation 30.8. Grip strength was 51% of the unaffected side. The average DASH score was 26. The intensity of the pain, measured by VAS, was reduced by 44% after strenuous activities and by 71% at rest. The Mayo and Krimmer wrist scores were 55 and 62 points indicating good results; 32 patients returned to work and 25 patients to their former occupation. Our results show that proximal row carpectomy is a technically easy operation that preserves a satisfying ROM and pain relief, and is recommended when the head of the capitate and the lunate fossa are not affected by arthrosis.

Details

Original languageGerman
Pages (from-to)308-312
Number of pages5
JournalScandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery
Volume42
Issue number6
Publication statusPublished - 2008
Peer-reviewedYes

External IDs

PubMed 18991174
Scopus 57349197926
ORCID /0000-0003-4633-2695/work/145698781

Keywords

Keywords

  • DASH-questionnaire, Wrist arthrosis, Carpal collapse, Proximal row carpectomy