Proximal row carpectomy: a worthwhile salvage procedure.

After proximal row carpectomy 11 patients were evaluated in the six ensuing years for pain relief, satisfaction, ranges of movement, grip and precision grip strength, and radiographic picture. The median follow-up period was 3.1 years (range 4 months to 6 years). They were operated on for scaphoid non-union with radiocarpal arthritis, late stage Kienböck's disease, chronic scapholunate dissociation and scapholunate advanced collapse wrist deformity. The mean disabilities of the arm, shoulder and hand (DASH) scoring list, which indicates the patient's degree of disability 28% (range 2%-64%) of maximum disability for the function and symptom score. Flexion, extension, and radial and ulnar deviation of the wrist improved to 47% (range 21%-76%), 67% (range 41%-81%), 39% (range 25%-55%), and 81% (range 44%-90%) of the opposite wrist. Mean grip strength, 70% (range 22%-117%) of the opposite site, while the three precision grips improved between 72% and 79%. A review of previous studies of proximal row carpectomy showed results comparable with those of our study. Compared with other treatments, it is a dependable, relatively-simple procedure that gives reliable relief of pain, preserves functional ranges of movement and grip strength, and allows most patients to return to work.