Article

Proximal row carpectomy (PRC) and four-corner arthrodesis (4CA) are the two most
commonly performed surgical procedures to treat wrist arthritis. Postoperative
strength is one of the criteria for choosing between the two techniques. Some
authors believe that strength is correlated with residual carpal height. The goal
of this study was to determine if postoperative carpal height was predictive of
postoperative strength. This study consisted of two parts: a clinical evaluation
of grip strength after 4CA or PRC; anatomical and radiological measurements of
carpal height before and after 4CA or PRC. Grip strength was better preserved
after PRC (87.5%) than after 4CA (76.1%), when expressed relative to the opposite
hand (P=0.053). There was a significant decrease in carpal height for the PRC
group with a Youm's index of 0.37 versus 0.50 for the 4CA group (P<0.0001). Our
clinical results and analysis of the literature indicate that 4CA is not superior
to PRC when it comes to grip strength, whereas carpal height is significantly
decreased after PRC. The decreased tendon excursion after PRC is balanced by an
increase in joint stresses after 4CA.
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Langue : ANGLAIS