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Proximal row carpectomy in advanced kienbock's disease
ARTICLE IN PRESS PROXIMAL ROW CARPECTOMY IN ADVANCED KIENBOCK’S DISEASE L. DE SMET, PH ROBIJNS and I. DEGREEF From the Department of Orthopaedic Surgery, U.Z. Pellenberg, Weligerveld 1, Lubbeek (Pellenberg), Belgium
This retrospective study assessed the outcomes of 21 patients (16 male and 5 female, mean age 39 years) with advanced Kienbock’s disease treated by resection of the proximal carpal row. They were clinically reviewed. The mean follow-up was 67 months, with all but two patients having had a follow-up of 2 years. No or mild pain was being experienced by 13 patients, moderate pain by 3 and severe pain by 5. Grip strength increased from 19 kg pre-operatively to 26 kg postoperatively (or 65% of the normal contralateral side). There was a slight increase of mobility. The DASH score was 22 points (range 0–78) and the Patient Rated Wrist Score (PRWS) was 30 points (range 0–84). Two patients developed Complex Regional Pain Syndrome which was ongoing at the time of review and one developed a superficial wound infection. Proximal carpal row resection arthroplasty gave satisfactory results in patients with advanced Kienbock’s disease. Journal of Hand Surgery (British and European Volume, 2005) 30B: 6: 585–587 Keywords: wrist, Kienbo¨ck, lunatomalacia, proximal row carpectomy, outcome
et al., 1996) and a PRWS questionnaire (MacDermid et al., 1998). Complications were noted. The duration of the time of return to work was also noted. The operative technique has been described by several authors (Green, 1987; Neviaser, 1983; Schernberg et al., 1981). We used a longitudinal dorsal approach. The dorsal retinaculum was opened over the third compartment and the dorsal capsule was incised in a proximally based T-shape. Usually, the carpal bones were removed piecemeal, ‘‘en bloc’’ resection being rarely possible. The capsule and retinaculum were repaired anatomically. The wrist was then immobilized in a cast for 4 weeks. The pre-operative data were compared to the postoperative data with a paired T-test. Significance was set at Po0.05.
INTRODUCTION Several treatments for Kienbock’s disease have been reported. For patients with Lichtman stage 3 and 4 disease (Lichtman et al., 1977), the choice between a limited wrist arthrodesis or a salvage procedure, including full wrist arthrodesis, wrist denervation, total wrist arthroplasty or proximal row carpectomy, remains open for discussion. The purpose of this survey was to evaluate the outcome of proximal row carpectomy for patients with advanced Kienbo¨ck’s disease.
PATIENTS AND METHODS We reviewed all patients with advanced Kienbock’s disease of Lichtman stages 3 and 4, treated by proximal row carpectomy between 1992 and 2002. The preoperative records and X-ray films, when available, were examined. Not all patients agreed to have an X-ray and not all X-rays were performed in the same hospital, which made this part of the analysis difficult. All patients were called back for evaluation. There were 16 men and 5 women, with a mean age of 39 (range 21–68) years. The dominant hand (the right in all cases) was operated on 11 times, the non-dominant hand 10 times (9 times the left, once the right side). Pre-operative radiographs showed Lichtman stage 3a disease in 2 patients, stage 3b in 17 patients and stage 4 in 2 patients. The pain evaluation was the patient’s opinion: no pain, slight pain (only with heavy use) moderate pain (with daily use) and severe pain (same or worse than preo-peratively). We measured the range of motion with a hand-held goniometer, the grip strength with a Jamar dynamometer and the patients filled in a DASH score (Hudak
RESULTS The mean follow-up was 67 (range 12–138) months. Pain was absent or mild in 13 wrists, moderate in 3 and severe in 5, including the 2 patients with CRPS 1. In 16 of the wrists, there was a pain reduction. Mean wrist motion increased slightly. Flexion increased from 311 (SD 18.3) to 351 (SD 12.3) (P40:05), extension from 361 (SD 16.1) to 411 (SD 18,3) (P40:05); ulnar deviation from 191 (SD 11.9) to 251 (SD 6.5) (P40:05) and radial deviation from 101 (SD 7.5) to 161 (SD 5.7) (P ¼ 0:004). The increase in radial deviation was significant (paired T-test). The difference was not significant for extension, flexion and ulnar deviation. Grip strength improved from a mean of 19 kg (SD 9.5) pre-operatively to 26 kg (SD 11.6) post operatively (P ¼ 0:019), or 63% of the contralateral side (P ¼ 0:049). The contralateral grip strength was 41 kg 585
ARTICLE IN PRESS 586
THE JOURNAL OF HAND SURGERY VOL. 30B No. 6 DECEMBER 2005
(SD 12.3). There was an increase of grip strength in 15 cases and a decrease in 4 cases and the data was incomplete in 2 cases. The mean score on the DASH questionnaire was 22 (range 0–78) (0 ¼ no disability, 100 ¼ severe disability) (SD ¼ 27.1). The mean score on the PRWS questionnaire was 30 (range 0–83) (0 ¼ no pain, 100 ¼ very severe pain). Two patients developed Complex Regional Pain Syndrome Type 1 (CPRS 1). The first signs appeared within 4 weeks postoperatively and were still ongoing at the time of review. The mean time out of work in the 15 employed patients was 17 (range 3–39) weeks. Ten returned to their original job and five patients had to change to a lighter job. Three patients had no job preoperatively. One patient, aged 56 years, was retired. The two patients with CRPS 1 were still unemployed pre-operatively and still were unemployed at the time of review.
unaffected side. Radial deviation has, consistently, been the most reduced. A major criticism of proximal row carpectomy is weakness, which is believed to be secondary to the mechanical effect of the relative tendon lengthening. A literature review by Nagelvoort et al. (2002) on strength following proximal row carpectomy has been reported. They found the mean grip strength varied between 60% and 100% of the opposite side. Trankle et al. (2003), obtained only 54% of the contralateral grip strength in a series of 33 wrists. Only recent articles on proximal row carpectomy mention the DASH score. It ranges between 28 and 36 (Lukas et al., 2003; Streich et al., 2003; Trankle et al., 2003). A series of 51 patients having this procedure for a number of pathologies (including the patients of this survey) in our own department, with a minimum followup of 1 year, had a DASH score of 18 and a mean grip strength of 70% of the contralateral side (Robijns et al., in press). In post-traumatic cases, the DASH score was 16 (SD 16.8) (DASH ¼ 22). The difference is not statistically significant between the post-traumatic cases and those with Kienbo¨ck’s disease (DASH ¼ 16). The literature on treatment for Kienbo¨ck’s disease is overwhelming and it is beyond the purpose of this study to make a meta-analysis of the different solutions for advanced Kienbo¨ck disease. These include arthrodesis, proximal row carpectomy, replacement of the lunate with a silicone prosthesis, the pisiform or the head of the capitate, with or without associated intercarpal fusions, wrist denervation, total wrist arthroplasty and more creative procedures. Although most reported series are small, proximal row carpectomy in Kienbo¨ck’s disease mostly results in a favourable outcome (Crabbe, 1964; Culp et al., 1993; Green, 1987; Imbriglia et al., 1990;
DISCUSSION Proximal row carpectomy converts a complex link joint system to a simple hinge joint by creating a radiocapitate articulation. The result is not physiological and normal kinetics should not be expected, but clinical results are satisfactory in most follow-up series of this operation, whatever the primary pathology for which it was done (Table 1). Jebson et al. (2003) revealed only a trend toward an increasing prevalence and degree of osteoarthritis after a long follow-up of 13 years. The range of postoperative motion reported in prior studies has been variable, ranging from 40% to 60% of the
Table 1—Literature review of outcomes of proximal row carpectomy (grip strength) Author Jorgensen (1969) Inglis and Jones (1977) Schernberg et al. (1981) Imbriglia et al. (1990) Foucher and Chmiel (1992) Legre and Sassoon (1992)y Culp et al. (1993)y Tomaino et al. (1994) Begley and Engber (1994) Steenwerckx et al. (1997) Luchetti et al. (1998) Nakamura et al. (1998) Inoue and Miura, (1990) Nagelvoort et al. (2002) Welby and Alnot (2003) Streich et al. (2003) De Smet et al. (2005)
Total number of patients
Patients with Kienbo¨ck
Force %
% of patients with pain relief
22 13 20 27 20 143 20 23 14 27 9 7 16 11 27 17 21
12 4 5 5 4 15 6 7 14 9 3 7 4 4 9 2 21
109 100 NI 80 60 NI 67 79 72 60 77 62 63 70 74 73 63
86 100 89 96 68 72 76 87 64 81 100 71 88 100 80 93 75
Expressed as a percentage of contralateral side. y
Multicentre study.
DASH score
28 28 22
ARTICLE IN PRESS PROXIMAL ROW CARPECTOMY
Inglis and Jones, 1977; Inoue and Miura, 1990; Jorgensen, 1969; Nakamura et al., 1998; Neviaser, 1983, 1986). Theoretically, after proximal row carpectomy, the axial load is transmitted through the new radiocapitate joint and the (pre)arthritic lunate fossa can wear more rapidly. The largest series is the one of Begley and Engber (1994) with 14 patients, reporting satisfactory results, decrease of pain in all wrists, grip strength of 72% of the contralateral side, unchanged range of motion or slight improvement in 12 of the 14 patients after surgery and return to former employment of all patients. This study confirms the effectiveness of this treatment and supports the findings of Begley and Engber (1994). In this series of 14 patients, they all had less pain. In our series, 16 of the 21 patients (75%) experienced a pain reduction, while 5 did not. Two of them had a CRPS 1. The persisting pain in the other three could not be explained. We have also demonstrated an increase of range of motion and grip strength. Although the literature suggests that the outcome of proximal row carpectomy for other indications is more favourable, proximal row carpectomy is a good solution for advanced Kienbock disease and is comparable to other procedures for this wrist problem. With such reproducible, good results after proximal row carpectomy, we recommend this procedure for all stages 3 and 4 of Kienbock’s disease. Even when the head of the capitate or the lunate fossa shows degeneration on the pre-operative radiographs in stage 4 cases, a proximal row carpectomy can be performed and a satisfactory outcome obtained. References Begley BW, Engber WD (1994). Proximal row carpectomy in advanced Kienbock’s disease. Journal of Hand Surgery, 19A: 1016–1018. Culp RW, McGuigan FX, Turner MA, Lichtman DM, Osterman AL, McCarrol H (1993). Proximal row carpectomy: a multicenter study. Journal of Hand Surgery, 18A: 19–25. Crabbe W (1964). Excision of the proximal row of the carpus. Journal of Bone and Joint Surgery, 46B: 708–711. Foucher G, Chmiel Z (1992). Excision of the proximal row of the carpal bones. Apropos of 21 Pateints. Revue de Chirurgie Orthope´dique, 78: 372–378. Green DP (1987). Proximal row carpectomy. Hand Clinics, 3: 163–168. Hudak P, Amadio P, Bombardier C (1996). Development of an upper extremity outcome measure: the DASH. American Journal of Industrial Medicine, 29: 602–608. Imbriglia JF, Broudy AS, Hagberg WC, McKernan D (1990). Proximal row carpectomy: clinical evaluation. Journal of Hand Surgery, 15A: 426–430. Inglis AE, Jones EC (1977). Proximal row carpectomy for diseases of the proximal row. Journal of Bone and Joint Surgery, 59A: 460–463. Inoue G, Miura T (1990). Proximal row carpectomy in perilunate dislocations and lunatomalacia. Acta Orthopedica Scandinavica, 61: 449–452.
587
Jorgensen EC (1969). Proximal row carpectomy. An end result study of twenty-two cases. Journal of Bone and Joint Surgery, 51A: 1104–1111. Jebson PJ, Hayes EP, Engber WD (2003). Proximal row carpectomy: a minimum 10-year follow-up study. Journal of Hand Surgery, 28A: 561–569. Legre R, Sassoon D (1992). Multicentric study of 143 cases of resection of the proximal carpal bone. Annales de Chirurgie de la Main. Memb. Super, 11: 257–263. Lichtman D, Mack G, MacDonald R, Gunther S, Wilson J (1977). Kienbo¨ck disease: the role of silicone replacement arthroplasty. Journal of Bone and Joint Surgery, 59A: 899–908. Luchetti R, Soragni O, Fairplay T (1998). Proximal row carpectomy through a palmar approach. Journal of Hand Surgery, 23B: 406–409. Lukas B, Herter F, Englert A, Ba¨cker K (2003). The treatment of Carpal Collapse: proximal row carpectomy or limited midcarpal arthrodesis? A comparative study. Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 35: 304–309. MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH (1998). Patient rating of wrist pain and disability: a reliable and valid measurement tool. Journal of Orthopedic Trauma, 12: 577–586. Nagelvoort RW, Kon M, Schuurman AH (2002). Proximal row carpectomy: a worthwhile salvage procedure. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 36: 289–299. Nakamura R, Horii E, Watanabe K, Nakao E, Kato H, Tsudnoda K (1998). Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienbock’s disease. Journal of Hand Surgery, 23B: 741–745. Neviaser RJ (1983). Proximal row carpectomy for posttraumatic disorders of the carpus. Journal of Hand Surgery, 8: 301–305. Neviaser RJ (1986). On resection of the proximal row. Clinical Orthopedics, 202: 12–15. Robijns Ph, Degreef I, De Smet L. Proximal row carpectomy: an outcome study. Journal of Hand Surgery Am, in press. Schernberg G, Lamarque B, Genevray J, Gerard Y (1981). La re´section arthroplastique de la premie`re range´e des os du carpe. Annales de Chirurgie, 35: 269–274. Steenwerckx A, De Smet L, Zachee B, Fabry G (1997). Proximal row carpectomy: an alternative to wrist fusion. Acta Othopedica Belgica, 63: 1–7. Streich N, Martini AK, Daeke W (2003). Proximal row carpectomy in carpal collapse. Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 35: 299–303. Tomaino MM, Delsignore J, Burton RJ (1994). Long-term results following proximal row carpectomy. Journal of Hand Surgery, 19A: 694–703. Tra¨nkle M, Sauerbier M, Blum K, Bickert B, Germann G (2003). Proximal row carpectomy: a motion-preserving procedure in the treatment of advanced carpal collapse. Unfallchirurg, 106: 1010–1015. Welby F, Alnot JY (2003). Resection of the first row of carpal bones: post-tramatic wrist and Kienbock’s disease. Chirurgie de la Main, 22: 148–153. Received: 21 December 2004 Accepted after revision: 29 June 2005 L. De Smet, Department of Orthopedic Surgery, U.Z. Pellenberg, Weligerveld, 1, B-3212 Lubbeek (Pellenberg), Belgium. Tel.: +32 016 338800; fax: +32 016 338803 E-mail: [email protected]
r 2005 The British Society for Surgery of the Hand. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jhsb.2005.06.024 available online at http://www.sciencedirect.com
This retrospective study assessed the outcomes of 21 patients (16 male and 5 female, mean age 39 years) with advanced Kienbock’s disease treated by resection of the proximal carpal row. They were clinically reviewed. The mean follow-up was 67 months, with all but two patients having had a follow-up of 2 years. No or mild pain was being experienced by 13 patients, moderate pain by 3 and severe pain by 5. Grip strength increased from 19 kg pre-operatively to 26 kg postoperatively (or 65% of the normal contralateral side). There was a slight increase of mobility. The DASH score was 22 points (range 0–78) and the Patient Rated Wrist Score (PRWS) was 30 points (range 0–84). Two patients developed Complex Regional Pain Syndrome which was ongoing at the time of review and one developed a superficial wound infection. Proximal carpal row resection arthroplasty gave satisfactory results in patients with advanced Kienbock’s disease. Journal of Hand Surgery (British and European Volume, 2005) 30B: 6: 585–587 Keywords: wrist, Kienbo¨ck, lunatomalacia, proximal row carpectomy, outcome
et al., 1996) and a PRWS questionnaire (MacDermid et al., 1998). Complications were noted. The duration of the time of return to work was also noted. The operative technique has been described by several authors (Green, 1987; Neviaser, 1983; Schernberg et al., 1981). We used a longitudinal dorsal approach. The dorsal retinaculum was opened over the third compartment and the dorsal capsule was incised in a proximally based T-shape. Usually, the carpal bones were removed piecemeal, ‘‘en bloc’’ resection being rarely possible. The capsule and retinaculum were repaired anatomically. The wrist was then immobilized in a cast for 4 weeks. The pre-operative data were compared to the postoperative data with a paired T-test. Significance was set at Po0.05.
INTRODUCTION Several treatments for Kienbock’s disease have been reported. For patients with Lichtman stage 3 and 4 disease (Lichtman et al., 1977), the choice between a limited wrist arthrodesis or a salvage procedure, including full wrist arthrodesis, wrist denervation, total wrist arthroplasty or proximal row carpectomy, remains open for discussion. The purpose of this survey was to evaluate the outcome of proximal row carpectomy for patients with advanced Kienbo¨ck’s disease.
PATIENTS AND METHODS We reviewed all patients with advanced Kienbock’s disease of Lichtman stages 3 and 4, treated by proximal row carpectomy between 1992 and 2002. The preoperative records and X-ray films, when available, were examined. Not all patients agreed to have an X-ray and not all X-rays were performed in the same hospital, which made this part of the analysis difficult. All patients were called back for evaluation. There were 16 men and 5 women, with a mean age of 39 (range 21–68) years. The dominant hand (the right in all cases) was operated on 11 times, the non-dominant hand 10 times (9 times the left, once the right side). Pre-operative radiographs showed Lichtman stage 3a disease in 2 patients, stage 3b in 17 patients and stage 4 in 2 patients. The pain evaluation was the patient’s opinion: no pain, slight pain (only with heavy use) moderate pain (with daily use) and severe pain (same or worse than preo-peratively). We measured the range of motion with a hand-held goniometer, the grip strength with a Jamar dynamometer and the patients filled in a DASH score (Hudak
RESULTS The mean follow-up was 67 (range 12–138) months. Pain was absent or mild in 13 wrists, moderate in 3 and severe in 5, including the 2 patients with CRPS 1. In 16 of the wrists, there was a pain reduction. Mean wrist motion increased slightly. Flexion increased from 311 (SD 18.3) to 351 (SD 12.3) (P40:05), extension from 361 (SD 16.1) to 411 (SD 18,3) (P40:05); ulnar deviation from 191 (SD 11.9) to 251 (SD 6.5) (P40:05) and radial deviation from 101 (SD 7.5) to 161 (SD 5.7) (P ¼ 0:004). The increase in radial deviation was significant (paired T-test). The difference was not significant for extension, flexion and ulnar deviation. Grip strength improved from a mean of 19 kg (SD 9.5) pre-operatively to 26 kg (SD 11.6) post operatively (P ¼ 0:019), or 63% of the contralateral side (P ¼ 0:049). The contralateral grip strength was 41 kg 585
ARTICLE IN PRESS 586
THE JOURNAL OF HAND SURGERY VOL. 30B No. 6 DECEMBER 2005
(SD 12.3). There was an increase of grip strength in 15 cases and a decrease in 4 cases and the data was incomplete in 2 cases. The mean score on the DASH questionnaire was 22 (range 0–78) (0 ¼ no disability, 100 ¼ severe disability) (SD ¼ 27.1). The mean score on the PRWS questionnaire was 30 (range 0–83) (0 ¼ no pain, 100 ¼ very severe pain). Two patients developed Complex Regional Pain Syndrome Type 1 (CPRS 1). The first signs appeared within 4 weeks postoperatively and were still ongoing at the time of review. The mean time out of work in the 15 employed patients was 17 (range 3–39) weeks. Ten returned to their original job and five patients had to change to a lighter job. Three patients had no job preoperatively. One patient, aged 56 years, was retired. The two patients with CRPS 1 were still unemployed pre-operatively and still were unemployed at the time of review.
unaffected side. Radial deviation has, consistently, been the most reduced. A major criticism of proximal row carpectomy is weakness, which is believed to be secondary to the mechanical effect of the relative tendon lengthening. A literature review by Nagelvoort et al. (2002) on strength following proximal row carpectomy has been reported. They found the mean grip strength varied between 60% and 100% of the opposite side. Trankle et al. (2003), obtained only 54% of the contralateral grip strength in a series of 33 wrists. Only recent articles on proximal row carpectomy mention the DASH score. It ranges between 28 and 36 (Lukas et al., 2003; Streich et al., 2003; Trankle et al., 2003). A series of 51 patients having this procedure for a number of pathologies (including the patients of this survey) in our own department, with a minimum followup of 1 year, had a DASH score of 18 and a mean grip strength of 70% of the contralateral side (Robijns et al., in press). In post-traumatic cases, the DASH score was 16 (SD 16.8) (DASH ¼ 22). The difference is not statistically significant between the post-traumatic cases and those with Kienbo¨ck’s disease (DASH ¼ 16). The literature on treatment for Kienbo¨ck’s disease is overwhelming and it is beyond the purpose of this study to make a meta-analysis of the different solutions for advanced Kienbo¨ck disease. These include arthrodesis, proximal row carpectomy, replacement of the lunate with a silicone prosthesis, the pisiform or the head of the capitate, with or without associated intercarpal fusions, wrist denervation, total wrist arthroplasty and more creative procedures. Although most reported series are small, proximal row carpectomy in Kienbo¨ck’s disease mostly results in a favourable outcome (Crabbe, 1964; Culp et al., 1993; Green, 1987; Imbriglia et al., 1990;
DISCUSSION Proximal row carpectomy converts a complex link joint system to a simple hinge joint by creating a radiocapitate articulation. The result is not physiological and normal kinetics should not be expected, but clinical results are satisfactory in most follow-up series of this operation, whatever the primary pathology for which it was done (Table 1). Jebson et al. (2003) revealed only a trend toward an increasing prevalence and degree of osteoarthritis after a long follow-up of 13 years. The range of postoperative motion reported in prior studies has been variable, ranging from 40% to 60% of the
Table 1—Literature review of outcomes of proximal row carpectomy (grip strength) Author Jorgensen (1969) Inglis and Jones (1977) Schernberg et al. (1981) Imbriglia et al. (1990) Foucher and Chmiel (1992) Legre and Sassoon (1992)y Culp et al. (1993)y Tomaino et al. (1994) Begley and Engber (1994) Steenwerckx et al. (1997) Luchetti et al. (1998) Nakamura et al. (1998) Inoue and Miura, (1990) Nagelvoort et al. (2002) Welby and Alnot (2003) Streich et al. (2003) De Smet et al. (2005)
Total number of patients
Patients with Kienbo¨ck
Force %
% of patients with pain relief
22 13 20 27 20 143 20 23 14 27 9 7 16 11 27 17 21
12 4 5 5 4 15 6 7 14 9 3 7 4 4 9 2 21
109 100 NI 80 60 NI 67 79 72 60 77 62 63 70 74 73 63
86 100 89 96 68 72 76 87 64 81 100 71 88 100 80 93 75
Expressed as a percentage of contralateral side. y
Multicentre study.
DASH score
28 28 22
ARTICLE IN PRESS PROXIMAL ROW CARPECTOMY
Inglis and Jones, 1977; Inoue and Miura, 1990; Jorgensen, 1969; Nakamura et al., 1998; Neviaser, 1983, 1986). Theoretically, after proximal row carpectomy, the axial load is transmitted through the new radiocapitate joint and the (pre)arthritic lunate fossa can wear more rapidly. The largest series is the one of Begley and Engber (1994) with 14 patients, reporting satisfactory results, decrease of pain in all wrists, grip strength of 72% of the contralateral side, unchanged range of motion or slight improvement in 12 of the 14 patients after surgery and return to former employment of all patients. This study confirms the effectiveness of this treatment and supports the findings of Begley and Engber (1994). In this series of 14 patients, they all had less pain. In our series, 16 of the 21 patients (75%) experienced a pain reduction, while 5 did not. Two of them had a CRPS 1. The persisting pain in the other three could not be explained. We have also demonstrated an increase of range of motion and grip strength. Although the literature suggests that the outcome of proximal row carpectomy for other indications is more favourable, proximal row carpectomy is a good solution for advanced Kienbock disease and is comparable to other procedures for this wrist problem. With such reproducible, good results after proximal row carpectomy, we recommend this procedure for all stages 3 and 4 of Kienbock’s disease. Even when the head of the capitate or the lunate fossa shows degeneration on the pre-operative radiographs in stage 4 cases, a proximal row carpectomy can be performed and a satisfactory outcome obtained. References Begley BW, Engber WD (1994). Proximal row carpectomy in advanced Kienbock’s disease. Journal of Hand Surgery, 19A: 1016–1018. Culp RW, McGuigan FX, Turner MA, Lichtman DM, Osterman AL, McCarrol H (1993). Proximal row carpectomy: a multicenter study. Journal of Hand Surgery, 18A: 19–25. Crabbe W (1964). Excision of the proximal row of the carpus. Journal of Bone and Joint Surgery, 46B: 708–711. Foucher G, Chmiel Z (1992). Excision of the proximal row of the carpal bones. Apropos of 21 Pateints. Revue de Chirurgie Orthope´dique, 78: 372–378. Green DP (1987). Proximal row carpectomy. Hand Clinics, 3: 163–168. Hudak P, Amadio P, Bombardier C (1996). Development of an upper extremity outcome measure: the DASH. American Journal of Industrial Medicine, 29: 602–608. Imbriglia JF, Broudy AS, Hagberg WC, McKernan D (1990). Proximal row carpectomy: clinical evaluation. Journal of Hand Surgery, 15A: 426–430. Inglis AE, Jones EC (1977). Proximal row carpectomy for diseases of the proximal row. Journal of Bone and Joint Surgery, 59A: 460–463. Inoue G, Miura T (1990). Proximal row carpectomy in perilunate dislocations and lunatomalacia. Acta Orthopedica Scandinavica, 61: 449–452.
587
Jorgensen EC (1969). Proximal row carpectomy. An end result study of twenty-two cases. Journal of Bone and Joint Surgery, 51A: 1104–1111. Jebson PJ, Hayes EP, Engber WD (2003). Proximal row carpectomy: a minimum 10-year follow-up study. Journal of Hand Surgery, 28A: 561–569. Legre R, Sassoon D (1992). Multicentric study of 143 cases of resection of the proximal carpal bone. Annales de Chirurgie de la Main. Memb. Super, 11: 257–263. Lichtman D, Mack G, MacDonald R, Gunther S, Wilson J (1977). Kienbo¨ck disease: the role of silicone replacement arthroplasty. Journal of Bone and Joint Surgery, 59A: 899–908. Luchetti R, Soragni O, Fairplay T (1998). Proximal row carpectomy through a palmar approach. Journal of Hand Surgery, 23B: 406–409. Lukas B, Herter F, Englert A, Ba¨cker K (2003). The treatment of Carpal Collapse: proximal row carpectomy or limited midcarpal arthrodesis? A comparative study. Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 35: 304–309. MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH (1998). Patient rating of wrist pain and disability: a reliable and valid measurement tool. Journal of Orthopedic Trauma, 12: 577–586. Nagelvoort RW, Kon M, Schuurman AH (2002). Proximal row carpectomy: a worthwhile salvage procedure. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, 36: 289–299. Nakamura R, Horii E, Watanabe K, Nakao E, Kato H, Tsudnoda K (1998). Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienbock’s disease. Journal of Hand Surgery, 23B: 741–745. Neviaser RJ (1983). Proximal row carpectomy for posttraumatic disorders of the carpus. Journal of Hand Surgery, 8: 301–305. Neviaser RJ (1986). On resection of the proximal row. Clinical Orthopedics, 202: 12–15. Robijns Ph, Degreef I, De Smet L. Proximal row carpectomy: an outcome study. Journal of Hand Surgery Am, in press. Schernberg G, Lamarque B, Genevray J, Gerard Y (1981). La re´section arthroplastique de la premie`re range´e des os du carpe. Annales de Chirurgie, 35: 269–274. Steenwerckx A, De Smet L, Zachee B, Fabry G (1997). Proximal row carpectomy: an alternative to wrist fusion. Acta Othopedica Belgica, 63: 1–7. Streich N, Martini AK, Daeke W (2003). Proximal row carpectomy in carpal collapse. Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 35: 299–303. Tomaino MM, Delsignore J, Burton RJ (1994). Long-term results following proximal row carpectomy. Journal of Hand Surgery, 19A: 694–703. Tra¨nkle M, Sauerbier M, Blum K, Bickert B, Germann G (2003). Proximal row carpectomy: a motion-preserving procedure in the treatment of advanced carpal collapse. Unfallchirurg, 106: 1010–1015. Welby F, Alnot JY (2003). Resection of the first row of carpal bones: post-tramatic wrist and Kienbock’s disease. Chirurgie de la Main, 22: 148–153. Received: 21 December 2004 Accepted after revision: 29 June 2005 L. De Smet, Department of Orthopedic Surgery, U.Z. Pellenberg, Weligerveld, 1, B-3212 Lubbeek (Pellenberg), Belgium. Tel.: +32 016 338800; fax: +32 016 338803 E-mail: [email protected]
r 2005 The British Society for Surgery of the Hand. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jhsb.2005.06.024 available online at http://www.sciencedirect.com