[Proximal row carpectomy in carpal collapse].
Proximal row carpectomy (PRC) is a generally accepted procedure in the treatment of an advanced radiocarpal arthrosis. The aim of this retrospective study was the evaluation of individual, functional and radiological results after proximal row carpectomy. Seventeen patients (15 male, two female) who had undergone proximal row carpectomy between 1991 and 1999, were reviewed. The most common indication was degenerative arthrosis secondary to carpal collapse associated with chronic scaphoid nonunion (SNAC), scapholunate advanced collapse (SLAC) deformity, late Kienböck's disease or perilunate dislocations. Clinical and subjective results were assessed using different scores (DASH-, modified Mayo wrist-score) and evaluating the individual wrist range of motion. Anteroposterior and lateral X-rays were obtained for radiological analysis. At follow-up evaluation (mean 65.4 months), the majority of patients reported pain relief and a significant increased range of motion for the operated wrist. Radiographical analysis showed degenerative changes at the radiocapitate articulation in ten patients. The intermediate-term results of this review would suggest that proximal row carpectomy is an effective procedure providing pain relief and a satisfactory range of motion in a variety of pathologic wrist disorders. Because of eventual radiocapitate arthrosis, we suggest PRC only in patients without significant degenerative changes at the proximal pole of the capitate or the lunate fossa.
Sektion für Hand- und Mikrochirurgie, Stiftung Orthopädische Universitätsklinik Heidelberg, Abteilung Orthopädie I.
N A
NA
Streich
A K
AK
Martini
W
W
Daecke
D000328:Adult; D000368:Aged; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery*