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Original Article



Clinical outcomes of proximal row carpectomy

Yener Aydin, Caner Mesut Mataraci, muhammet Kalkisim, Burc Ozcanyuz, Mehmet Yildiz.




Abstract

OBJECTIVE: The aim of this study was to assess the clinical outcomes of the patients who underwent proximal row carpectomy due to wrist arthritis and to evaluate the influence of terminal branch of posterior interosseous nerve (PIN) neurectomy on the clinical outcomes.
MATERIAL AND METHOD: Thirty three patients who underwent proximal row carpectomy for various etiologic reasons between 2000 and 2018 were evaluated retrospectively. Twenty patients (13 males, 7 females) who came to the controls regularly and whose clinical records were kept regularly were included in the study. Functional subjective outcomes were assessed by The Quick Disability of the Arm, Shoulder and Hand (Q-DASH) Questionnaire, Patient Rated Wrist Evaluation (PRWE), Mayo Modified Wrist Score, Visual Analogue Scale (VAS) preoperatively and postoperatively. Additionally, wrist range of motion and grip strength were recorded
RESULTS: The mean age of 20 patients was 48.25±16.09 (range 24-79 years). Postoperative mean follow-up time was 52.6 ± 56.68 months (6-216 months). Q-DASH, PRWE, VAS scores were statistically lower in the last follow-up from postoperatively. Mayo Modified Wrist Score increased from 29.25 to 68 postoperatively. Wrist flexion extension range of motion was 65.15° preoperatively and rose significantly to 87.05° postoperatively (p=0.001). Grip strength was 16.09 kg preoperatively whereas it reached up 25.84 kg postoperatively (p=0.001). PIN neurectomy was performed in 14 (70%) patients and no statistically (p>0,05) significant contribution to clinical results of PIN neurectomy was found.
CONCLUSION: In wrist arthritis related to various etiological causes, application of proximal row carpectomy is easier and lead to lesser complication. Proximal row carpectomy may provide promising results when applied to suitable patients appropriately. PIN neurectomy, on the other hand, had no considerable contribution to the outcomes.
Keywords: Proximal row carpectomy, wrist arthritis, posterior interosseous nerve, neurectomy, SNAC, SLAC, Kienböck disease
Level of study: Level IV

Key words: Neurectomy, Posterior interosseous nerve, Proximal row corpectomy, SLAC, SNAC, Wrist arthritis.






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