Long-term outcomes of proximal row carpectomy in patients younger than 45 years: A minimum 10-year follow-up study.

Abstract

Proximal row carpectomy is a well-established surgical procedure for treating various wrist pathologies that is frequently performed in patients over 45 years of age owing to its reliability and low complication rate. However, its effectiveness in younger patients with high functional demands remains debated, given the potential for subsequent failure. We aimed to assess the long-term outcomes of proximal row carpectomy in a population <45 years old, with an average follow-up of 15.55 years. A retrospective study was conducted on 36 patients who underwent proximal row carpectomy between 2002 and 2013 at the University Hospital of Modena. Functional outcomes, including range of motion, grip and pinch strength were assessed. Additionally, demographic data, occupation, pain levels and radiographic parameters were analyzed. Furthermore, outcomes were compared between volar and dorsal surgical approaches. The operated wrist retained 67% of active range of motion and 61% of grip strength compared to the contralateral side. These values improved in patients with lower osteoarthritis grades and non-manual occupations, though pinch strength remained unchanged. Pain was not considerably associated with radiographic findings. Outcomes were similar between the volar and dorsal approaches. Higher pain levels correlated with reduced grip and pinch strength but with a wider active range of motion in the healthy wrist. Proximal row carpectomy provides acceptable long-term outcomes in patients under 45 years of age. Functional results are influenced by osteoarthritis severity and occupational demands, whereas surgical approach does not significantly affect the outcomes. Retrospective cohort study, Level 2b evidence, Prognostic.