Surgical Treatment of Wrist Arthritis in Young Patients.

JBJS Rev · Mar 2020 · Review

Campbell CC, Neustein TM, Daly CA, Wagner ER

Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia

Hand & Upper Extremity

SUMMARY — THE REDUCTIONFor young patients with wrist arthritis, proximal row carpectomy and four-corner fusion reliably relieve pain if the lunate facet is spared, and selective neurectomy is a promising adjunct; other options need more study.
Abstract, as published

Surgical treatment of wrist arthritis in the younger patient population remains a challenging issue, and various surgical options need to be carefully considered for each patient. Proximal row carpectomy and 4-corner arthrodesis have proven to be reliable options for reducing pain and restoring adequate function in most young high-demand patients if the lunate facet is spared. Selective neurectomy has proven to be a promising stand-alone or complementary procedure for the treatment of pain that is associated with wrist arthritis in patients of all ages, with spared motion and the opportunity to perform additional procedures if pain continues. Alternative procedures, including capitolunate arthrodesis, total wrist arthrodesis, radial styloidectomy, total wrist arthroplasty, and wrist hemiarthroplasty, have considerable strengths and weaknesses and need to be studied further in younger patients.

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