title: [Complete wrist denervation: a retrospective study of 27 cases with a mean follow-up period of 77 months].
abstract: OBJECTIVE
  Complete wrist denervation is a palliative operation, which yields still controversial outcomes. The aim of our study is to assess the late outcomes of complete wrist denervation.
  
  
  METHODS
  In a retrospective continuous review of 27 complete and isolated denervations of the wrist joint performed by the same surgeon in 27 patients (15 men for 12 women) from 1995 to 2007, the pain (VAS), the function (Dash-score), the range of motion, the strength (Jamar) and the radiological changes were assessed at a mean follow-up period of 77 months (12 to 157).
  
  
  RESULTS
  At final follow-up, 12 patients (44%) were completely free of pain and 11 (41%) had little pain, four (15%) had moderate and severe pain. The average time to achieve the complete pain relief was 3 months and 3 weeks. Pain relief was stable over time in 89% of cases. There was a significant improvement in range of motion: 11° flexion/extension; 8° pronosupination. In average, the Jamar grip strength was 85% of the healthy side. The Dash-score was in average 30.4 (22 to 60). The extension of the osteoarthritic surface was observed in 14 patients (52%). Six complications were noted: one complex regional pain syndrome, five neuromas four of which resolved spontaneously. Two patients were re-operated. Eighteen patients were very satisfied (67%), six patients were satisfied (22%) and three patients were moderately satisfied (11%).
  
  
  CONCLUSIONS
  Complete wrist denervation is an intervention with few complications indicated in chronic wrist pain of any aetiology.
authors.affiliation: Service de chirurgie orthopédique traumatologique et réparatrice, CHU de Brest, 29200 Brest, France. erwan.simon@chu-brest.fr
authors.forename: E
authors.initials: E
authors.lastname: Simon
authors.forename: A
authors.initials: A
authors.lastname: Zemirline
authors.forename: J
authors.initials: J
authors.lastname: Richou
authors.forename: W
authors.initials: W
authors.lastname: Hu
authors.forename: D
authors.initials: D
authors.lastname: Le Nen
mesh_terms: D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D003714:Denervation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014955:Wrist Joint / Q000294:innervation* / Q000503:physiopathology / Q000601:surgery*