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Surgeons Hit the Delete Button on a Row of Wrist Bones
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Posted on: 11/30/1999
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You're about to read the checklist for a surgeon doing a proximal row carpectomy (PRC) in the wrist. Anesthesia . . . incision . . . separate tissue . . . move tendons . . . find the wrist joint . . . remove the capsule . . . take out a row of bones. What? Take out a row of wrist bones? You heard correctly. The doctor may decide to remove a row of bones in the wrist when trauma or arthritis is causing constant pain and collapse of the joint.
Doctors in this study followed 20 patients who got PRC for up to 17 years. They hoped to find out what kind of results PRC patients have in the long run. A physical exam, X-rays, and a patient survey were used to measure results. Wrist range of motion, grip strength, and the shape of the bones left in the wrist were used to determine success or failure. Pain and return to work were also measured.
None of the patients felt the wrist was weak. Most returned to work even when their job required manual labor. A small number of patients had pain and needed another operation later. Wrist range of motion was better than half of normal, and grip strength was at least 80 percent of the other side.
The authors conclude PRC is a dependable and durable operation with good results. The remaining joint doesn't collapse and isn't destroyed over time. The authors plan to keep following patients with a PRC for as long as possible to see if wrist pain or problems come back in later years.
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References:
Peter J. L. Jebson, MD, et al. Proximal Row Carpectomy: A Minimum 10-Year Follow-Up Study. In The Journal of Hand Surgery. July 2003. Vol. 28A. No. 4. Pp. 561-569.
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