The Efficacy of Proximal Row Carpectomy

Duke Whan Chung; Chung Soo Han; Jung Chul Hwang; Eun Suck Son

doi:10.4055/jkoa.2008.43.4.473

Journal List > J Korean Orthop Assoc > v.43(4) > 1012812

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Chung, Han, Hwang, and Son: The Efficacy of Proximal Row Carpectomy

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(4): 473-478.

Published online: 31 August 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.4.473

The Efficacy of Proximal Row Carpectomy

Duke Whan Chung, M.D., Chung Soo Han, M.D., Jung Chul Hwang, M.D., Eun Suck Son, M.D.

Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

Address reprint requests to Duke Whan Chung, M.D. Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-ku, Seoul 130-701, Korea. Tel: +82.2-958-8368, Fax: +82.2-964-3865, dukech@khmc.or.kr

Abstract

Purpose

To evaluate the effects of proximal row carpectomy.

Materials and Methods

We performed a retrospective review of the cases of 14 patients who had undergone proximal row carpectomy between April 1996 and January 2006. All of the patients were men with an average age of 37.5 years (range, 25-64 years). The mean follow-up period was 59 months (range, 18-101months). Evaluation of results was based on x-ray analysis, pain relief, the ability to return to work, activity level, range of motion (ROM) and grip strength. Pain relief was classified as very satisfied, satisfied, dissatisfied and very dissatisfied.

Results

The subjective results of pain relief were very satisfied in 6 cases, satisfied in 7 cases, dissatisfied in 1 case. 7 cases (50%) returned to previous occupations and 11 cases (79%) had little restriction on their daily activities. The total arc was improved from average 42 degree to 59 degree. The grip strength using Jamar dynanometer was increased from average 7.8 lbs (10.5% of the unaffected side) to average 33 lbs (44% of the unaffected side).

Conclusion

Proximal row carpectomy is an effective surgery with preserving ROM and function for patients with wrist pain and diminished function if it is done within proper indication.

Keywords: Wrist, Proximal row, Proximal row carpectomy

Figures and Tables

Fig. 1

Case 1. Post-traumatic arthritis of the carpus was developed in a 38-year-old male patient who had fallen down. Proximal row carpectomy resulted in diminished wrist pain and a 45 degree flexion-15 degree extension motion arc. (A) Preoperative radiograph. (B) Postoperative radiograph. (C, D) Radiographs of the postoperative 3 year 6 months.

Fig. 2

Case 2. Radiographs of a 48-year-old male patient with an old neglected perilunate dislocation. (A, B) Preoperative radiographs show dorsal perilunate dislocation. (C, D) Radiographs of the postoperative 1 year 6 months.

References

1. Almguist EE. Kienböck's disease. Hand Clin. 1987. 3:141–148.

2. Calandruccio JH, Gelberman RH, Duncan SF, Goldfarb CA, Pae R, Gramig W. Capitolunate arthrodesis with scaphoid and triquetrum excision. J Hand Surg Am. 2000. 25:824–832.

3. Clendenin MB, Green DP. Arthrodesis of the wrist-complications and their management. J Hand Surg Am. 1981. 6:253–257.

4. Crabbe WA. Excision of the proximal row of the carpus. J Bone Joint Surg Br. 1964. 46:708–711.

5. Culp RW, McGuiqan FX, Turner MA, Lichtman DM, Osterman AL, McCarroll HR. Proximal row carpectomy: a multicenter study. J Hand Surg Am. 1993. 18:19–25.

6. Ferlic DC, Clayton ML, Mills MF. Proximal row carpectomy: review of rheumatoid and nonrheumatoid wrists. J Hand Surg Am. 1991. 16:420–424.

7. Fitzgerald JP, Peim CA, Smith RJ. Distraction resection arthroplasty of the wrist. J Hand Surg Am. 1989. 14:774–781.

8. Imbriglia JE, Broudy AS, Hagberg WC, McKernan D. Proximal row carpectomy: clinical evaluation. J Hand Surg Am. 1990. 15:426–430.

9. Inglis AE, Jones EC. Proximal-row carpectomy for diseases of the proximal row. J Bone Joint Surg Am. 1977. 59:460–463.

10. Inoue G, Miura T. Proximal row carpectomy in perilunate dislocations and lunatomalacia. Acta Orthop Scand. 1990. 61:449–452.

11. Jebson PJ, Hayes EP, Engber WD. Proximal row carpectomy: a minimum 10-year follow-up study. J Hand Surg Am. 2003. 28:561–569.

12. Krakauer JD, Bishop AT, Cooney WP. Surgical treatment of scapholunate advanced collapse. J Hand Surg Am. 1994. 19:751–759.

13. Nagelvoort RW, Kon M, Schuurman AH. Proximal row carpectomy: a worthwhile salvage procedure. Scand J Plast Reconstr Surg Hand Surg. 2002. 36:289–299.

14. Neviaser RJ. On resection of the proximal carpal row. Cinic Orthop Relat Res. 1986. 202:12–15.

15. Stamm TT. Excision of the proximal row of the carpus. Proc R Soc Med. 1944. 38:74–75.

16. Swanson AB, de Groot Swanson G, Maupin BK. Flexible implant arthroplasty of the radiocarpal joint. Surgical technique and long-term study. Clin Orthop Relat Res. 1984. 187:94–106.

17. Tomaino MM, Miller RJ, Cole I, Burton RI. Scapholunate advanced collapse wrist: proximal row carpectomy or limited wrist arthrodesis with scaphoid excision? J Hand Surg Am. 1994. 19:134–142.

18. Volz RG. Total wrist arthroplasty. A clinical review. Cinic Orthop Relat Res. 1984. 187:112–120.

19. Watson HK, Goodman ML, Johnson TR. Limited wrist arthrodesis. Part II: Intercarpal and radiocarpal combinations. J Hand Surg Am. 1981. 6:223–233.

20. Wyrick JD, Stern PJ, Kiefhaber TR. Motion-preserving procedures in the treatment of scapholunate advanced collapse wrist: proximal row carpectomy versus four-corner arthrodesis. J Hand Surg Am. 1995. 20:965–970.

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