Carpectomy
What Is Wrist Carpectomy?
Wrist carpectomy, also called proximal row carpectomy (PRC), is a surgical procedure where the first row of small wrist bones (the scaphoid, lunate, and triquetrum) are removed. This creates a new joint between the remaining wrist bones and the radius (forearm bone). The goal is to relieve pain while preserving as much wrist motion as possible.
When Is It Needed?
Your doctor may recommend wrist carpectomy if you have:
- Arthritis affecting the scaphoid, lunate, or triquetrum bones.
- Chronic wrist pain that does not improve with medications, splints, or injections.
- Avascular necrosis (bone death) of the lunate or scaphoid.
- Post-traumatic arthritis after wrist injury.
- Desire to preserve wrist motion instead of undergoing wrist fusion.
The Procedure Step-by-Step
- Evaluation – X-rays and scans confirm the extent of damage.
- Anesthesia –General or regional anesthesia is given.
- Removal – The surgeon removes the scaphoid, lunate, and triquetrum bones.
- New joint formation – The capitate bone (in the second row) now articulates directly with the radius.
- Closure – The incision is closed, and recovery begins.
Recovery and Rehabilitation
- Hospital stay:Usually 1–2 days.
- Immobilization:A cast or splint is worn for several weeks.
- Physiotherapy: Essential to restore movement and strength.
- Return to activities: Daily activities resume in 6–12 weeks; heavy work may take longer.
Benefits
- Relieves pain from arthritis or bone damage.
- Preserves partial wrist motion compared to wrist fusion.
- Improves function and independence.
- Long-lasting results for selected patients.
Risks & Considerations
- Reduced wrist motion compared to a healthy wrist.
- Possible complications: infection, stiffness, or progression of arthritis in remaining bones.
- Not suitable for patients with widespread wrist arthritis.
- Some patients may eventually require wrist fusion if symptoms persist.
Key Message for Patients
Wrist carpectomy is a safe and effective surgery for patients with localized wrist arthritis or bone damage. By removing the first row of wrist bones, the procedure relieves pain while preserving partial wrist motion. With proper rehabilitation, most patients regain good function and enjoy long-term relief
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