Total wrist denervation: Retrospective study of 39 wrists with 56 months’ follow-up - 06/09/19

Doi : 10.1016/j.otsr.2019.04.024

Baptiste Picart ⁎ , Clément Laborie, Christophe Hulet, Mélanie Malherbe
Department of Orthopedics and Traumatology, Caen University Hospital, 14000 Caen, France

^⁎Corresponding author. Chirurgie orthopédique et traumatologique, CHU de Côte de Nacre, avenue de la Côte de Nacre, 14000 Caen, France.Chirurgie orthopédique et traumatologique, CHU de Côte de Nacreavenue de la Côte de NacreCaen14000France

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Abstract

Introduction

The objective of this study was to analyze patient satisfaction after total wrist denervation.

Hypothesis

Total wrist denervation provides reliable and durable results.

Material and method

A single-center multi-surgeon retrospective study included a cohort of 39 wrists. Mean age was 58 years. The dominant side was operated on in two-thirds of cases. SLAC wrist and SNAC wrist accounted for 41% of etiologies. All patients were seen again in consultation and were evaluated for pain, strength, mobility and limb function. Failure was defined as any reoperation.

Results

Mean follow-up was 56 months, with no loss to follow-up. Pain improved in 79.5% of cases. Median DASH score was 27.27. Strength on Jamar® dynamometer improved from 60% to 75% compared to the contralateral side (p=0.012). Range of motion improved by 5° (p=0.052). At last follow-up, 31% of patients showed aggravation of radiological osteoarthritis. There were 4 revision procedures (total wrist fusion), and 4 complications.

Discussion

The present results were comparable to those in the literature in terms of satisfaction, functional scores and number of complications and revision procedures. Total wrist denervation is a reliable and reproducible surgical technique in terms of pain relief preservation of function in painful osteoarthritic wrists. It thus has an essential place in the therapeutic algorithm of patients presenting with chronic pain in a wrist that is still mobile, whatever the initial etiology.