Proximal Row Carpectomy for Advanced Wrist Arthritis

Kim, Joo Hak; Jung, Woo Sun; Lee, Kwang Hyun

Article

Journal of the Korean Society for Surgery of the Hand 2006;11(4):246-251.
Published online December 1, 2006.

Proximal Row Carpectomy for Advanced Wrist Arthritis

Joo Hak Kim, Woo Sung Jung, Kwang Hyun Lee

진행된 수근 관절염에 대한 근위 수근열 절제술

김주학, 정우성, 이광현

Correspondence: Kwang Hyun Lee, Tel: 02-2290-8482, Fax: 02-2299-3774,
Email: leegh@hanyang.ac.kr

Abstract

Purpose
Proximal row carpectomy for non-inflammatory advanced wrist arthritis was regarded as a kind of salvage procedure. But recently it is regarded as reconstructive option of wrist arthritis because of its usefulness in pain reduction and preservation of motion. We assess the result of proximal row carpectomy from radiographic and clinical point of view. Also we assess the usefulness of this procedure in daily life.
Materials and Methods: Between 1995 and 2005, 9 patients (10 cases) who underwent proximal row carpectomy for the treatment of advanced wrist arthritis and was capable of minimum 1 year follow up were included. There were 5 men and 4 women with a mean age of 46.1 years. We used the Criteria of Culp et al. for evaluation of radiologic change. For evaluation of clinical result, we measured wrist motion, grip strength and DASH score preoperatively and postoperatively.

Results
The underlying diagnosis were Kienbo¨ck’s disease in five of the wrist, scaphoid nonunion advanced collapse in two, arthritis after lunate fracture in two and scapholunate advanced collapse combined with scaphoid avascular necrosis in one. Flexion and extension arc was improved from 65 degrees to 92.5 degrees (p=0.009), and grip strength was also improved from mean 20.1 kg to mean 26.8 kg (p=0.007). VAS score for pain and DASH score were decreased after the operation.

Conclusion
Proximal row carpectomy for the treatment of advanced wrist arthritis was very useful procedure in the point of pain reduction and motion sparing. And it was very useful in daily-life.

Key Words: Wrist, Arthritis, Proximal row carpectomy