[The mid-term results of proximal row carpectomy in the treatment of degenerative wrist joint derangements].
OBJECTIVE
We evaluated the mid-term results of proximal row carpectomy (PRC) in patients who underwent treatment for wrist joint derangements.


METHODS
Nine patients (4 men, 5 women; mean age 38 years; range 23 to 66 years) underwent PRC to relive pain in the wrist joint and to improve motion and grip strength. Indications for surgery were acute transscaphoid-perilunate fracture dislocation in one patient, formerly unreduced perilunate fracture dislocation in one patient, Kienbock's disease in four patients, and scaphoid nonunion associated with scapholunate advanced collapse (SLAC) in three patients. The duration of the symptoms ranged from eight months to 10 years. The results were assessed with the use of pre- and postoperative clinical and radiographic studies, and measurements of active and passive motion, grip strength, and pulp and key pinch strengths. The mean follow-up was 35.4 months (range 13.5 to 72 months).


RESULTS
Postoperatively, pain relief was achieved in all the patients and no complications were encountered in the early period. One patient with acute transscaphoid-perilunate fracture dislocation developed radiocapitate joint degeneration three years after surgery and underwent total wrist arthrodesis. Compared to the uninvolved side, wrist functions were found adequate with painless motion, except for passive radial deviation which exhibited a significant decrease (p<0.05). Age, sex, and the duration of symptoms did not influence postoperative results.


CONCLUSIONS
In selected patients with wrist joint derangement, PRC enables painless and adequate motion and grip strength for daily activities. However, radial styloidectomy seems to be necessary to prevent restriction in radial deviation.
Gündeş
Hakan
H
Department of Orthopedics and Traumatology, Division of Hand Surgery, Medicine Faculty of Kocaeli University, Kocaeli, Turkey. hakangundes@yahoo.com
Kurt
Hakan
H
Buluç
Levent
L
Ergüner
Hatice
H
D000328:Adult; D000368:Aged; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*