Hand Surgery and Orthopedics Unit, Department of Orthopaedics and Traumatology, University Hospital A. Gemelli IRCCS, Rome.
Department of Hand Surgery, Modena University Hospital, Modena, Italy.
Tech Hand Up Extrem Surg. 2021 Jan 4;25(4):213-218. doi: 10.1097/BTH.0000000000000335.
Proximal row carpectomy (PRC) is a long-time, well-accepted, easy-to-reproduce procedure for the treatment of several painful degenerative conditions of the wrist, when capitate pole and radius lunate fossa are preserved. It has been reported to relieve pain and preserve a substantial wrist range of motion, although a partial loss of strength has to be expected because of the decreased length of the carpus. Since 2010, a new technique has been described in the literature using the resurfacing capitate pyrocarbon implant, combined with PRC. This implant has been designed to perform PRC even in the presence of degenerate joint surfaces, and thus resolves the limited indications of this procedure; however, if a resection of the capitate pole is performed to set up the implant, similar to PRC it may not positively influence the recovery of strength. The authors propose an resurfacing capitate pyrocarbon implant technique without any capitate bone resection, to preserve as much as possible the carpus length and so to improve the functional recovery. The surgical technique, is described in detail and preliminary results are discussed.
近排腕骨切除术（PRC）是一种长期以来被广泛接受的、易于复制的手术方法，适用于治疗几种腕部疼痛性退行性疾病，同时保留头状骨杆和月骨窝。据报道，该手术可以缓解疼痛并保留大量的腕关节活动度，尽管由于腕骨长度缩短，预计会有部分力量丧失。自 2010 年以来，文献中已经描述了一种新的技术，使用表面置换的头状骨 pyrolytic carbon 植入物，结合 PRC。这种植入物的设计目的是即使在关节表面退化的情况下也能进行 PRC，从而解决了该手术的局限性适应证；然而，如果为了安装植入物而切除头状骨杆，类似于 PRC，它可能不会对力量的恢复产生积极影响。作者提出了一种不进行任何头状骨骨切除的头状骨表面置换 pyrocarbon 植入物技术，以尽可能保留腕骨长度，从而改善功能恢复。详细描述了手术技术，并讨论了初步结果。
