written by: Victoria Trix
• edited by: Leigh A. Zaykoski
• updated: 10/26/2009
Carpectomy is the removal of a carpal bone or parts of the carpus. The carpal bone is located in the hand, and is the main focus of carpal tunnel disorder. The carpectomy is used in severe cases of arthritis of the wrist or scapholunate dissociation with radioscaphoid arthritis.
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There are many diseases and disorders that are linked to the carpectomy, where part or all of the carpal bones are removed. These include many forms of arthritis that are crippling, as well as scaphoid non-union or radiocarpal arthritis, late stage Kienbock’s disease, chronic scapholunate dissociation and advanced collapse wrist deformities, according to doctors Ryan P. Calfee, M.D., and Peter J. Stern, M.D. The surgery is used to help keep range of motion and flexion as well as extension of the radial and ulnar deviation of the wrist. For those patients to be able to continue to use the affected wrist, this surgery is imperative to quality of life.
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Complications of Carpectomy
Few complications are seen with this invasive surgery. Serious complications of carpectomy include the wound not healing properly, infections and sensitive movement. Few patients require further surgery due to radiocapitate arthrosis, as the majority of cases can continue regular activities after a few months of aftercare. Other complications that may arise include general surgery complications, such as general anesthesia allergies or side effects, infection due to incisions and range of movement problems during healing periods. The postoperative complication rate is extremely low, with numbers in the area of 5%. Persistent restriction of the radial bone is possible in some cases if the entire carpus is removed.
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Many patients that undergo follow up exams are free of all painful symptoms after the healing period is complete. Some do experience pain with heavy physical use or stress, whereas a small amount of patients have minute pain during normal activity. There have not been any cases reported of pain when the joint is at rest after the surgery has been completed and recovery time has passed.
Most are able to continue prior occupations, with the exception of those who experience severe pain with heavy use or stress. Follow up periods at 6 years postoperative, patients with late stage Kienbock’s disease were found to have no disabilities at all, flexion and extension of the wrist was improved an additional average of 38%, and the grip strength of all patients was improved an average of 77%. When proximal row carpectomy is used results are about the same as the average carpectomy procedure in comparison of treatments, grip, strength and flexion.