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Proximal row carpectomy in total arthrodesis of the rheumatoid wrist
- Source :
- Orthopaedics and Traumatology-Surgery and Research, Orthopaedics and Traumatology-Surgery and Research, Elsevier, 2015, 101 (8), pp.919-922. ⟨10.1016/j.otsr.2015.09.032⟩
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- Background Advanced proximal carpal row damage is common in rheumatoid arthritis (RA). Proximal row carpectomy (PRC) simplifies total wrist arthrodesis, obviating the need for an iliac bone graft. In theory, PRC also improves the chances of healing, as fusion of a single joint space is needed for the procedure to be successful. Potential effects of the loss of carpal height related to PRC are unknown. Hypothesis We hypothesised that PRC performed concomitantly with total wrist arthrodesis in patients with RA produces good clinical and radiological outcomes, without inducing loss of strength or digital deformities. Material and methods In 38 total arthrodeses of rheumatoid wrists, a clinical evaluation was performed, including a visual analogue scale (VAS) pain score, the Patient-Rated Wrist Evaluation (PRWE), grip strength, digital deformities, and patient satisfaction. A standard radiographic workup was obtained to assess healing and carpal height indices. Results After a mean follow-up of 50 months, the mean VAS pain score was 0.4 (range: 0–7), the mean PRWE score was 21 (range: 0–80.5), and grip strength as a percentage of the contralateral limb was 76%. The healing rate was 92% (35/38 wrists), and 34 (90%) patients reported being satisfied or very satisfied. No effects of carpal height loss on clinical or radiographic parameters was detected. Discussion Total wrist arthrodesis combined with PRC provides reliable and reproducible benefits. This study found no evidence of adverse effects related to the loss of carpal height. Level of evidence IV, retrospective study.
- Subjects :
- Adult
Male
Wrist Joint
musculoskeletal diseases
medicine.medical_specialty
Visual analogue scale
Arthrodesis
medicine.medical_treatment
Synovectomy
[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
030230 surgery
Wrist
Proximal row carpectomy
Arthritis, Rheumatoid
03 medical and health sciences
Grip strength
0302 clinical medicine
Hand strength
medicine
Humans
Orthopedics and Sports Medicine
Rheumatoid arthritis
Carpal Bones
Aged
Retrospective Studies
Aged, 80 and over
030222 orthopedics
Hand Strength
business.industry
Middle Aged
medicine.disease
Arthralgia
Surgery
Radiography
body regions
Carpal bones
medicine.anatomical_structure
[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system
Patient Satisfaction
Female
business
Subjects
Details
- ISSN :
- 18770568
- Volume :
- 101
- Database :
- OpenAIRE
- Journal :
- Orthopaedics & Traumatology: Surgery & Research
- Accession number :
- edsair.doi.dedup.....1b5ca3eb1af405a719380758d8fd83b0