Proximal Row Carpectomy in Young Patients.

JBJS Essential Surgical Techniques
Eric R WagnerSteven L Moran

Abstract

There continues to be controversy regarding the treatment of early-stage arthritis of the wrist, particularly in young patients, because of the large number of techniques, the poor long-term results for many of these techniques, and the overall paucity of high-level scientific data. Proximal row carpectomy (PRC) and 4-corner arthrodesis (4CA) have been established as the mainstay motion-sparing surgical treatment options in cases of early scapholunate advanced collapse and scaphoid nonunion advanced collapse arthritis. However, there is marked controversy surrounding the best treatment option for younger patients with greater physical demands because of the questionable outcomes associated with these motion-sparing options in such patients1-9. Traditionally, many surgeons prefer 4CA over PRC for young, high-demand patients, in part because studies have suggested that young age and work status as a laborer are important risk factors for worse outcomes following PRC1,8. However, the concern for symptomatic nonunion and potential for radiolunate arthritis in 4CA, as well as the lack of medium to long-term comparative studies in this subset, make this recommendation controversial10. The wrist is accessed via the dorsal approach, cr...Continue Reading

References

Sep 1, 1994·The Journal of Hand Surgery·J D KrakauerW P Cooney
Aug 2, 2003·The Journal of the American Academy of Orthopaedic Surgeons·John D Wyrick
Nov 2, 2013·Journal of Wrist Surgery·Harvey Chim, Steven L Moran
Apr 16, 2017·The Journal of Hand Surgery·Eric R WagnerSteven L Moran

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