Abstract

Excision of the proximal carpal row has proven over the past 60 years to be an effective technique for certain disorders of the wrist, including degenerative sequelae of scapholunate ligament dissociation and scaphoid nonunions, Kienböck disease, Preisser disease, and other fracture-dislocations of the wrist. The durability of this procedure may be due to remodeling of the capitate head to the lunate fossa. Poor results have been noted in patients with rheumatoid arthritis and arthrogrypotic wrist deformities. Preservation of relatively normal cartilage of the capitate head as well as the lunate fossa is critical for success of this procedure. Average outcomes of this procedure include a wrist extension-flexion arc of 75° and grip strength of 60% of the uninvolved wrist. Revision to total wrist arthrodesis is required in 10% of patients. Approximately 90% have pain relief and can return to moderate use activity. Copyright © 2001 by the American Society for Surgery of the Hand

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