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Proximal row carpectomy.
J Bone Joint Surg Am. 2005 Sep; 87 Suppl 1(Pt 2):166-74.JB

Abstract

BACKGROUND

Proximal row carpectomy is an accepted motion-sparing surgical procedure for the treatment of degenerative conditions of the wrist. However, there is little information regarding the long-term clinical and radiographic results following this procedure.

METHODS

Twenty-two wrists in twenty-one patients underwent proximal row carpectomy for the treatment of degenerative arthritis between 1980 and 1992. Objective and subjective function was assessed after a minimum duration of follow-up of ten years (average, fourteen years).

RESULTS

There were four failures (18%) requiring fusion at an average of seven years. All four failures occurred in patients who were thirty-five years of age or less at the time of the proximal row carpectomy (p = 0.03). The wrists that did not fail had an average flexion-extension arc of 72 degrees , associated with an average grip strength of 91% of that on the contralateral side. The patients were very satisfied with fourteen of the eighteen wrists that did not fail and were satisfied with the remaining four. The patients rated nine wrists as not painful, four as mildly painful, five as moderately painful, and none as severely painful. The average Disabilities of the Arm, Shoulder and Hand score was 9 points. Radiographs revealed no loss of the radiocapitate space in three of the seventeen wrists for which radiographs were made, reduced space in seven, and complete loss of the space in seven. With the numbers available, there was no significant association between loss of joint space seen on radiographs and subjective and objective function.

CONCLUSIONS

At the time of long-term followup, all patients older than thirty-five years of age at the time of a proximal row carpectomy had maintained a satisfactory range of motion, grip strength, and pain relief and were satisfied with the result. Caution should be exercised in performing the procedure in patients younger than thirty-five years of age. Although degeneration of the radiocapitate joint was seen radiographically in fourteen of the seventeen wrists, it did not preclude a successful clinical result.

Authors+Show Affiliations

Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, P.O. Box 670212, Cincinnati, OH 45267-0212, USA. sternpj@ucmail.uc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16140792

Citation

Stern, Peter J., et al. "Proximal Row Carpectomy." The Journal of Bone and Joint Surgery. American Volume, vol. 87 Suppl 1, no. Pt 2, 2005, pp. 166-74.
Stern PJ, Agabegi SS, Kiefhaber TR, et al. Proximal row carpectomy. J Bone Joint Surg Am. 2005;87 Suppl 1(Pt 2):166-74.
Stern, P. J., Agabegi, S. S., Kiefhaber, T. R., & Didonna, M. L. (2005). Proximal row carpectomy. The Journal of Bone and Joint Surgery. American Volume, 87 Suppl 1(Pt 2), 166-74.
Stern PJ, et al. Proximal Row Carpectomy. J Bone Joint Surg Am. 2005;87 Suppl 1(Pt 2):166-74. PubMed PMID: 16140792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proximal row carpectomy. AU - Stern,Peter J, AU - Agabegi,Steven S, AU - Kiefhaber,Thomas R, AU - Didonna,Michael L, PY - 2005/9/6/pubmed PY - 2005/11/3/medline PY - 2005/9/6/entrez SP - 166 EP - 74 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 87 Suppl 1 IS - Pt 2 N2 - BACKGROUND: Proximal row carpectomy is an accepted motion-sparing surgical procedure for the treatment of degenerative conditions of the wrist. However, there is little information regarding the long-term clinical and radiographic results following this procedure. METHODS: Twenty-two wrists in twenty-one patients underwent proximal row carpectomy for the treatment of degenerative arthritis between 1980 and 1992. Objective and subjective function was assessed after a minimum duration of follow-up of ten years (average, fourteen years). RESULTS: There were four failures (18%) requiring fusion at an average of seven years. All four failures occurred in patients who were thirty-five years of age or less at the time of the proximal row carpectomy (p = 0.03). The wrists that did not fail had an average flexion-extension arc of 72 degrees , associated with an average grip strength of 91% of that on the contralateral side. The patients were very satisfied with fourteen of the eighteen wrists that did not fail and were satisfied with the remaining four. The patients rated nine wrists as not painful, four as mildly painful, five as moderately painful, and none as severely painful. The average Disabilities of the Arm, Shoulder and Hand score was 9 points. Radiographs revealed no loss of the radiocapitate space in three of the seventeen wrists for which radiographs were made, reduced space in seven, and complete loss of the space in seven. With the numbers available, there was no significant association between loss of joint space seen on radiographs and subjective and objective function. CONCLUSIONS: At the time of long-term followup, all patients older than thirty-five years of age at the time of a proximal row carpectomy had maintained a satisfactory range of motion, grip strength, and pain relief and were satisfied with the result. Caution should be exercised in performing the procedure in patients younger than thirty-five years of age. Although degeneration of the radiocapitate joint was seen radiographically in fourteen of the seventeen wrists, it did not preclude a successful clinical result. SN - 0021-9355 UR - https://www.unboundmedicine.com/medline/citation/16140792/Proximal_row_carpectomy_ L2 - https://doi.org/10.2106/JBJS.E.00261 DB - PRIME DP - Unbound Medicine ER -