Proximal row carpectomy for scapholunate dissociation

Thirty-one patients underwent proximal row carpectomy for static scapholunate dissociation without degenerative arthritis. We report the radiographic and clinical results including wrist range of motion, grip strength, use of pain medication, pain severity and patient satisfaction. Mean postoperative flexion/extension was 74° (range 5°-150°) compared with 137° (range 70°-175°) for the uninvolved side. Mean grip strength was 22 kg for the involved side and 39 kg for uninvolved side. Fifteen of 31 patients reported moderate or severe pain after proximal row carpectomy, requiring wrist arthrodesis in four patients. Nearly half of patients involved in manual labour did not return to their pre-injury work status. Our findings suggest that proximal row carpectomy, when performed for static scapholunate dissociation, results in a stiffened, weakened wrist. When compared to historic series involving other treatments for scapholunate dissociation, patients are less likely to return to pre-injury occupation and have subjective and objective parameters that are below normally expected values after proximal row carpectomy performed for other conditions.