Proximal row carpectomy: Is early postoperative mobilisation the right rehabilitation protocol?
OBJECTIVE
To determine the feasibility and interest of an early rehabilitation protocol with no initial immobilisation after proximal row carpectomy.


METHODS
Thirteen patients were included in this retrospective study. Range of motion (ROM) and wrist strength (grip strength and grasp strength) were evaluated 3 and 6 weeks after surgery on the both wrists (operated and non-operated). Postoperatively, patients had no immobilisation of the wrist, and began a rehabilitation program immediately after surgery in the department of Physical Therapy and Rehabilitation under multidisciplinary team supervision. The same surgical technique was used for all patients by the same surgeon.


RESULTS
Six weeks after PRC, there was a 25-51% deficit in passive ROM and 54-64% deficit in active ROM compared to the corresponding non-operated wrist. Six weeks after PRC, mean overall grip strength was nearly 55% and Jamar dynamometer grip strength was 51% of the contralateral side.


CONCLUSIONS
This study shows that immediate immobilisation following PRC is unnecessary, and that early rehabilitation is of the essence. Early rehabilitation could reduce the delay necessary to recover range of motion and strength, and probably the time to return to work.


METHODS
Level 4, prospective cohort study.
Edouard
P
P
Department of Physical Medicine and Rehabilitation, LPE EA 4338, Bellevue Hospital, University Hospital of Saint-Etienne, 42055 Saint-Etienne cedex 2, France. Pascal.Edouard42@gmail.com
Vernay
D
D
Martin
S
S
Hirsch
P
P
Bardoux
S
S
Grange
C
C
Claus
D
D
Claise
J-M
JM
D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D002348:Carpal Bones / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D026741:Physical Therapy Modalities; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000503:physiopathology / Q000534:rehabilitation*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013165:Splints; D014954:Wrist Injuries / Q000601:surgery*; D014955:Wrist Joint / Q000503:physiopathology