Proximal Row Carpectomy in Degenerative Wrist Conditions. Our Medium-term Experience

DOI: https://doi.org/10.15417/issn.1852-7434.2024.89.4.1843
Keywords: Carpectomy, row, resection

Abstract

Objective: Examining the medium-term clinical and radiological outcomes of proximal carpectomy for treating degenerative wrist conditions. Materials and Methods: Retrospective study of 33 patients who underwent proximal carpectomy between 2009 and 2019. Outcomes were assessed through range of motion measurements, pain evaluation using the Visual Analog Scale (VAS), and functional capacity using the Quick-DASH questionnaire. Biomechanical tests were performed and the rate of complications and reoperations was analyzed. Radiological progression of osteoarthritis and its impact on clinical outcomes were examined. Results: The mean range of motion was 77.11º (range 51–80º) in flexion-extension and 36.7º (range 29–42º) in radioulnar deviation. VAS scores improved significantly from 7.9 (range 7–9) to 2.7 (range 0–7) post-surgery (p<0.003). The Quick-DASH score at the final follow-up was 24.3 (range 11–45). We observed an inverse relationship between preoperative radiocarpal osteoarthritis severity and clinical outcomes (p<0.03), but no link between postoperative osteoarthritis progression and poor outcomes (p<0.04). Four patients (12.12%) required reoperation with total wrist arthrodesis. Conclusions: Proximal carpectomy demonstrates satisfactory medium-term outcomes for degenerative wrist conditions, offering good range of motion and a low complication rate. However, patients with more severe preoperative joint degeneration may lead to poorer clinical outcomes.

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Author Biographies

Clara Matellanes Palacios, Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Isabel Cabanes Ferrer, Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Miguel Alfonso Porcar, Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Gemma Gázquez Gázquez, Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Ana Losar Sogues Colom, Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Laura Castillo Ruipérez, Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Upper Limb Unit, Hospital General Universitario de Valencia, Spain
José Garrido Ferrer, Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Lorenzo Hernández Ferrando, Upper Limb Unit, Hospital General Universitario de Valencia, Spain
Head of Orthopedic and Traumatology Department, Upper Limb Unit, Hospital General Universitario de Valencia, Spain

References

Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT). Manual de cirugía ortopédica y

traumatología. 2ª ed. Madrid: Panamericana; 2010, p. 978-85.

Uceda Carrascosa P, Izquierdo Fernández A, Múñoz Reyes F, Carpintero R, Peces Gonjar D, Serrano Lázaro P, et

al. Carpectomía proximal en osteoartritis de muñeca. Rev Soc Andal Traumatol Ortop 2011;28(2):100-9. Disponible en: https://www.portalsato.es/documentos/revista/Revista11-2/Rev.%202011-2-03.pdf

Montiel V, Payo-Ollero J, Amillo S. Resección de la primera fila del carpo en pacientes mayores de 50 años: 3 a 16 años de seguimiento. Rev Esp Cir Ortop Traumatol 2019;63(4):295-9. https://doi.org/10.1016/j.recot.2019.02.001

Stamm TT. Excision of the proximal row of the carpus. Proc R Soc Med 1944;38(2):74-5. PMID: 19992990

Berkhout MJL, Bachour Y, Zheng KH, Mullender MG, Strackee SD, Ritt MJPF. Four-corner arthrodesis versus proximal row carpectomy: A retrospective study with a mean follow-up of 17 years. J Hand Surg Am 2015;40(7):1349-54. https://doi.org/10.1016/j.jhsa.2014.12.035

Amer KM, Thomson JE, Vosbikian MM, Ahmed I. Four-corner arthrodesis versus proximal row carpectomy for

scapholunate advanced collapse: A systematic literature review and meta-analysis. Ann Plast Surg 2020;85(6):699-703. https://doi.org/10.1097/SAP.0000000000002398

Rahgozar P, Zhong L, Chung KC. A comparative analysis of resource utilization between proximal row carpectomy and partial wrist fusion: A population study. J Hand Surg Am 2017;42(10):773-80. https://doi.org/10.1016/j.jhsa.2017.07.032

Chammas PE, Hadouiri N, Chammas M, Ramos-Pascual S, Stirling P, Nover L, et al. Proximal row carpectomy

generates better mid- to long-term outcomes than four-corner arthrodesis for post-traumatic wrist arthritis: A metaanalysis. Orthop Traumatol Surg Res 2022;108(7):103373. https://doi.org/10.1016/j.otsr.2022.103373

Watson HK, Ballet FL. The SLAC wrist: scapholunate advanced collapse pattern of degenerative arthritis. J Hand

Surg Am 1984;9(3):358-65. https://doi.org/10.1016/s0363-5023(84)80223-3

De Carli P, Zaidenberg E. Enfermedad de Kienböck: conceptos actuales. Rev Asoc Argent Ortop Traumatol

;85(Supl.):S26-S35. https://doi.org/10.15417/issn.1852-7434.2020.85.4S.1170

Escribano Rey R, Flórez Alvarez F, Duart J, Amillo S. Resección de la primera fila del carpo: indicaciones y resultados. Rev Esp Cir Osteoartic 2008;43(234):60-4. Disponible en: http://www.cirugia-osteoarticular.org/

adaptingsystem/intercambio/revistas/articulos/35_05_reseccion%20primera%20fila.pdf

Jebson PJL, Hayes EP, Engber WD. Proximal row carpectomy: a minimum 10-year follow-up study. J Hand Surg

Am 2003;28(4):561-9. https://doi.org/10.1016/s0363-5023(03)00248-x

Hudak PL, Amadio PC, Bombardier C, Beaton D, Cole D, Davis A, et al. Development of an upper extremity

outcome measure: The DASH (disabilities of the arm, shoulder, and head). Am J Ind Med 1996;29(6):602-8.

https://doi.org/10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L

Montero Vilela J, Baydal Bertomeu JM, Garrido Jaen JD, Bermejo Bosch I, Page Del Pozo AF, Porcar Seder RM,

et al. Objetivamos los gestos característicos de la mano. Revista de Biomecánica 2012;(58):47-0. Disponible en:

https://m.riunet.upv.es/bitstream/handle/10251/38483/MONTERO%3BBaydal%3BGarrido%20-%20Objetivamos%20los%20gestos%20caracter%C3%ADsticos%20de%20la%20mano.pdf?sequence=1&isAllowed=y

DiDonna ML, Kiefhaber TR, Stern PJ. Proximal row carpectomy: study with a minimum of ten years of follow-up. J Bone Joint Surg Am 2004;86(11):2359-65. PMID: 15523004

Green DP, Perreira AC, Longhofer LK. Proximal row carpectomy. J Hand Surg Am 2015;40(8):1672-6.

https://doi.org/10.1016/j.jhsa.2015.04.033

França Bisneto EN, Freitas MC, Paula EJL de, Mattar Jr R, Zumiotti AV. Comparison between proximal row

carpectomy and four-corner fusion for treating osteoarthrosis following carpal trauma: a prospective randomized study. Clinics (Sao Paulo) 2011;66(1):51-5. https://doi.org/10.1590/s1807-59322011000100010.13

El-Mowafi H, El-Hadidi M, El-Karef E. Proximal row carpectomy: a motion-preserving procedure in the treatment of advanced Kienbock’s disease. Acta Orthop Belg 2006;72(5):530-4. PMID: 17152414

Renart IP, Gómez CL, Pujals JI, Rodríguez JDC. Resección de la primera fila del carpo (Carpectomía proximal).

Revista Iberoamericana de Cirugía de la Mano 2005;33(67):22-30. https://doi.org/10.1055/s-0037-1606674

Richou J, Chuinard C, Moineau G, Hanouz N, Hu W, Le Nen D. Proximal row carpectomy: Long-term results.

Chir Main 2010;29(1):10-5. https://doi.org/10.1016/j.main.2009.10.003

Ali MH, Rizzo M, Shin AY, Moran SL. Long-term outcomes of proximal row carpectomy: a minimum of 15-year

follow-up. Hand (N Y) 2012;7(1):72-8. https://doi.org/10.1007/s11552-011-9368-y

Bijon C, Saab M, Amouyel T, Sturbois-Nachef N, Guerre E, Chantelot C. Long-term radiological changes and

functional outcomes after proximal row carpectomy: Retrospective study with 3 years’ minimum follow-up. Orthop Traumatol Surg Res 2020;106(8):1589-95. https://doi.org/10.1016/j.otsr.2020.03.038

Hogan CJ, McKay PL, Degnan GG. Changes in radiocarpal loading characteristics after proximal row carpectomy. J Hand Surg Am 2004;29(6):1109-13. https://doi.org/10.1016/j.jhsa.2004.07.006

Stern PJ, Agabegi SS, Kiefhaber TR, DiDonna ML. Proximal row carpectomy. J Bone Joint Surg Am 2005;87 Suppl 1(Pt 2):166-74. https://doi.org/10.2106/JBJS.E.00261

Rabinovich RV, Lee SJ. Proximal row carpectomy using decellularized dermal allograft. J Hand Surg Am 2018;43 (4):392.e1-392.e9. https://doi.org/10.1016/j.jhsa.2018.01.012

Ishida O, Tsai TM, Atasoy E. Long-term results of denervation of the wrist joint for chronic wrist pain. J Hand Surg Br 1993;18(1):76-80. https://doi.org/10.1016/0266-7681(93)90202-q

Published
2024-08-20
How to Cite
Matellanes Palacios, C., Cabanes Ferrer, I., Alfonso Porcar, M., Gázquez Gázquez, G., Losar Sogues Colom, A., Castillo Ruipérez, L., Garrido Ferrer, J., & Hernández Ferrando, L. (2024). Proximal Row Carpectomy in Degenerative Wrist Conditions. Our Medium-term Experience. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 89(4), 341-352. https://doi.org/10.15417/issn.1852-7434.2024.89.4.1843
Issue
Vol 89 No 4 (2024)
Section
Clinical Research
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