Proximal row carpectomy: a minimum 10-year follow-up study.
OBJECTIVE
To assess the long-term clinical and radiographic results after a proximal row carpectomy (PRC).


METHODS
Twenty patients with various degenerative and posttraumatic disorders of the wrist were evaluated. The evaluation consisted of a physical examination, plain radiographs, and completion of a questionnaire that assessed patient satisfaction, return to work status, occupational and recreational activities and restrictions, and pain level.


RESULTS
Two patients (10%) had persistent pain after a PRC requiring a radiocapitate arthrodesis. The remaining 18 patients were evaluated at an average follow-up of 13.1 years (range, 10.0-17.2 y). The average wrist range of motion was 63% and the average maximal grip strength was 83% of the opposite extremity, respectively. Seventeen patients were satisfied with their outcome. One patient complained of persistent pain and was not satisfied but did not want further surgery. All but 2 patients returned to their original occupation and activity level including all 5 patients involved in workers' compensation. Follow-up radiographs showed flattening of the proximal capitate in 6 patients. Radiocapitate arthrosis was absent/minimal in 13 patients and moderate/severe in 4 patients. The presence of radiographic changes did not correlate with patient satisfaction or degree of wrist pain.


CONCLUSIONS
Proximal row carpectomy is a dependable and durable procedure that results in satisfactory pain relief in the majority of patients, maintenance of functional wrist motion and grip strength, high patient satisfaction, and ability to return to work. Progressive symptomatic deterioration of the radiocapitate articulation was not observed.
Jebson
Peter J L
PJ
Department of Orthopaedic Surgery, University of Michigan Hospitals and Clinics, Ann Arbor, MI, USA.
Hayes
Edward P
EP
Engber
William D
WD
D000328:Adult; D000368:Aged; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D010147:Pain Measurement; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function / Q000502:physiology; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*