Retrospective study of 54 cases of wrist denervation

Most patients with post-traumatic and/or degenerative wrist arthritis present with pain and limitation of activities of daily living. Wrist denervation using a two-incision technique is an alternative to proximal row carpectomy and partial or total wrist arthrodesis. The purpose of this study was to evaluate whether two-incision denervation is a valid procedure for reducing pain in wrist arthritis of different etiologies.

A retrospective study of fifty-four patients, mean age 56 years, operated on by one senior surgeon at a single center was designed. Inclusion criteria were chronic wrist pain of various etiologies, patients with previous wrist surgery were excluded.

Preoperative pain was reported on a visual analog scale, and at least twelve months postoperatively, patient-rated wrist/hand assessment, pain, and range of motion were assessed.

Results

54.8% of the population presented with post-traumatic osteoarthritis of the wrist (scaphoid non-union advanced collapse or scapholunate advanced collapse).

71.5% of the population underwent surgery on the dominant extremity. After clinical evaluation, the mean PRWHE was 15.76 (±14.53), with total joint motion of 68° (±14.44), flexion 64.5° (±13.36), extension 76° (±7.71), pronation 72.4° (±6.20), and supination 74.8° (±9.21). The overall mean pain reduction was 60% and there were no re-operations.

Two-incision total wrist denervation is a valid technique for the treatment of wrist pain of various etiologies, leaving a good range of motion and acceptable autonomy in activities of daily living. If this technique fails, more invasive techniques such as proximal row carpectomy, partial or total wrist arthrodesis, and wrist arthroplasty can be used.