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Proximal Row Carpectomy and Intercarpal Arthrodesis for the Management of Wrist Arthritis

Dr. Wyrick is Assistant Professor, Department of Orthopaedic Surgery, Director, Division of Upper Extremity Surgery, and Associate Director, Division of Orthopaedic Trauma, University of Cincinnati, Cincinnati, OH.

Reprint requests: Dr. Wyrick, 231 Albert Sabin Way, Cincinnati, OH 45267-0212.

For advanced noninflammatory wrist arthritis, the most common surgical treatments to preserve motion are proximal row carpectomy and scaphoid excision with capitohamate-lunotriquetral arthrodesis. Both procedures have documented successful outcomes. Proximal row carpectomy is simpler but typically is contraindicated when degeneration of the capitate head cartilage exists. Scaphoid excision with capitohamate-lunotriquetral arthrodesis is more complex but may provide greater grip strength and can be successful in the presence of capitate degeneration. Treatment selection should be based on surgeon preference and experience as well as on the patient’s understanding of the possible complications and benefits of each procedure.

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