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CARPECTOMY: REPORT OF FOUR CASES



Abstract

Introduction and purpose: The widespread discredit which beset the resection of the proximal carpal row in the past seems to have disappeared. At present this is considered to be a very useful salvage technique with results which in some cases can surpass those of arthrodesis. This technique has been reported to yield a pain remission rate of 90% with a 20% loss of strength as compared with the contralateral hand.

Materials and methods: We set about analyzing the evolution and results obtained in 4 patients, three male and one female. Three of them were subjected to this procedure to correct a posttraumatic osteoarthritis; the other had an inveterate perilunate dislocation. In all cases the SF-12 health score was used to make an assessment of the functional condition of the patients as well as of their degree of satisfaction.

Results: All four patients expressed a high degree of satisfaction. Three of them do not take painkillers while the fourth – operated on 8 months ago – takes them sporadically. Three lead a normal life, whereas the patient who has had the shortest evolution has resumed work only partially. The loss of force in the operated wrist as compared with the contralateral one is of 19%. ROM at present is 46° for volar flexion, 26° for dorsal flexion, 10° for radial deviation and 15° for ulnar deviation. All of them were able to perform a handgrip correctly.

Conclusions: Carpectomy is a good alternative to wrist arthrodesis since it allows a good ROM and the ensuing loss of strength is moderate.

The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief of the Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be sent to him at Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos, 108, 28015-Madrid, Spain