Open AccessProximal Row Carpectomy in Young Patients
Author(s) -
Eric R. Wagner,
Laurel A. Barras,
Chelsea Harstad,
Bassem T. Elhassan,
Steven L. Moran
Publication year - 2021
Publication title -
jbjs essential surgical techniques
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 7
ISSN - 2160-2204
DOI - 10.2106/jbjs.st.19.00054
Subject(s) - medicine , lunate , surgery , arthrodesis , scapholunate ligament , wrist , nonunion , wrist pain , ligament , alternative medicine , pathology
There continues to be controversy regarding the treatment of early-stage arthritis of the wrist, particularly in young patients, because of the large number of techniques, the poor long-term results for many of these techniques, and the overall paucity of high-level scientific data. Proximal row carpectomy (PRC) and 4-corner arthrodesis (4CA) have been established as the mainstay motion-sparing surgical treatment options in cases of early scapholunate advanced collapse and scaphoid nonunion advanced collapse arthritis. However, there is marked controversy surrounding the best treatment option for younger patients with greater physical demands because of the questionable outcomes associated with these motion-sparing options in such patients 1-9 . Traditionally, many surgeons prefer 4CA over PRC for young, high-demand patients, in part because studies have suggested that young age and work status as a laborer are important risk factors for worse outcomes following PRC 1,8 . However, the concern for symptomatic nonunion and potential for radiolunate arthritis in 4CA, as well as the lack of medium to long-term comparative studies in this subset, make this recommendation controversial 10 .