Proximal Row Carpectomy

Through an incision over the back of the wrist, the surgeon removes the proximal row of small carpal bones that has become arthritic, allowing the remaining wrist bones to form a new, smoother joint surface. The procedure typically takes one to two hours and is usually day surgery.

Assessment includes examination and X-rays to confirm the pattern of arthritis is suitable for this procedure, as it depends on the remaining wrist joint surfaces being in reasonable condition. Standard preoperative preparation applies, including fasting and arranging transport home.

A cast or brace supports the wrist initially, with hand therapy introduced as healing allows. Recovery is gradual, with wrist function and strength continuing to improve over several months.

Rehabilitation focuses on restoring wrist movement and grip strength, adapting to the altered wrist mechanics following removal of the arthritic bones. Progress is guided by the hand therapist based on comfort and healing.

Risks include infection, stiffness, and, over time, some further wear at the remaining joint surfaces, which occasionally leads to the need for further surgery such as wrist fusion later on.

The aim is meaningful pain relief while preserving a functional range of wrist movement, generally more movement than a full wrist fusion but somewhat less than a healthy wrist. Most patients experience good symptom relief and are satisfied with the balance of pain relief and retained function.

Proximal row carpectomy relieves wrist pain from arthritis by removing a row of damaged small wrist bones, preserving a useful range of wrist movement while reducing pain. Most patients experience good relief and functional wrist use afterward.