Article

Proximal row carpectomy (PRC) is indicated for the treatment of SNAC or SLAC
wrist with preservation of the midcarpal joint. Our hypothesis was that PRC is
not appropriate for treating advanced wrist osteoarthritis in patients who carry
out heavy manual work. Twenty-three PRCs were performed on 21 patients, 5 women
and 16 men with an average age of 54 years (33-77). All patients performed manual
work; 11 of them performed heavy manual work. Etiologies were: SLAC wrist in 14
cases (2 stage III, 11 stage II, and 1 stage I) and SNAC wrist in 9 cases (6
stage IIIB and 3 stage IIB). At an average 75 months' follow-up (24-153), five
patients were lost to follow-up. Radiocarpal arthrodesis was performed in one
patient 10 years after the PRC. In the 17 remaining patients (18 wrists), pain
(VAS) averaged 2.2, with residual pain of 5. Flexion-extension range was similar
to preoperative levels (67% of contralateral wrist). Wrist strength was decreased
by 34% compared to preoperative. The QuickDASH score averaged 26 points and the
PRWE 20 points. Radiocapitate distance decreased by 0.3mm on average with joint
line narrowing in 6 patients. The carpal translation index was 0.33mm, which was
unchanged relative to preoperative values. Three patients had work-related
limitations that required retraining and one patient had to be reassigned. PRC
preserved the preoperative range of motion and reduced pain levels. However,
significant loss of strength was observed, resulting in 23% of manual workers
needing retraining or reassignment. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic
IV.
CI - Copyright A(c) 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS