Analgesic benefit, functional outcome, and patient satisfaction after partial wrist denervation.
Partial wrist denervation is a useful palliative procedure for chronic wrist pain when reconstructive procedures are not feasible or desirable. We reviewed 19 patients who had 20 isolated anterior and posterior interosseous neurectomies with no previous or concurrent wrist surgery in a 5-year period at our institution. At an average of 2.5 years postoperatively, 80% of patients reported a decrease in pain, 45% reported normal or increased grip strength, and 73% of employed patients had returned to work. Three patients required additional procedures for pain relief (2 arthrodesis, 1 radial styloidectomies). Failure tended to occur in the first postoperative year. Poor preoperative range of motion and workers' compensation status were predictive of failure. Failure also occurred in the single patient with rheumatoid arthropathy. Two patients had subsequent arthrodeses. There were no complications related to the surgery. Overall, 85% of patients reported satisfaction with this procedure; 90% retrospectively would choose the same treatment for their chronic wrist pain. Partial denervation of the wrist via the anterior and posterior interosseous nerves is a technically easy procedure and may provide pain relief sufficient to markedly delay the need for more extensive salvage procedures in patients with wrist arthritis.
Weinstein
Loryn P
LP
Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
Berger
Richard A
RA
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D003714:Denervation / Q000379:methods*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010148:Intractable Pain / Q000503:physiopathology / Q000601:surgery*; D010166:Palliative Care / Q000379:methods; D017060:Patient Satisfaction; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D014955:Wrist Joint / Q000294:innervation* / Q000503:physiopathology / Q000601:surgery*