Isolated Osseous Excision in the Adult Carpus: A Narrative Review.

J Hand Microsurg · Jun 2024 · Review

Dolan JD, Shiver L, Wallace D, Whitehead J, Wood M, Fulcher SM

Department of Orthopaedic Surgery, Medical College of Georgia, Augusta

Hand & Upper Extremity

SUMMARY — THE REDUCTIONNarrative review of isolated excision of each carpal bone: pisiform, trapezium, and trapezoid have good long-term support, while capitate, hamate, triquetrum, scaphoid, and lunate excision risks recurrent pain or carpal collapse.
Abstract, as published

Various pathologies of the adult carpus result in clinical scenarios where excision can be considered and even recommended. In the appropriate patient population, isolated carpal excision can alleviate pain and improve mobility. Excisions of the pisiform, trapezium, and trapezoid have abundant literature evidence to support positive long-term functional outcomes. In contrast, isolated excision of the capitate, hamate, and triquetrum has limited support in the literature secondary to compromise of carpal mechanics and lead to recurrent pain. Additionally, isolated scaphoid and lunate excision are best avoided secondary to carpal collapse and should be paired with concomitant stabilizing procedures in the carpus. This article provides a comprehensive literature review of isolated excision of each osseous carpal bone, their indications, and previously assessed outcomes.

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