Abstract
We performed proximal row carpectomy (PRC) and dorsal capsule interposition combined with the Sauve-Kapandji (S-K) procedure in 2 patients with severely damaged wrist joints.
One case was diagnosed as the terminal stage of Kienbock disease, complicated by a subcutaneous laceration of the deep flexor tendon of the index finger at the level of the segmented lunate, which was volarly dislocated.
The other case was thought to be advanced renal arthropathy, complicated by subcutaneous lacerations of the extensor tendons of the ring and little fingers at the level of the badly degenerated DRUJ.
In case 1, we performed flexor tenodesis of the DIP joint of the index finger, along with PRC and dorsal capsule interposition combined with the S-K procedure. In case 2, we performed extensor tendon transfer using the extensor indicis proprius tendon, along with PRC and dorsal capsule interposition combined with the S-K procedure.
Both patients were satisfied with the results, and they returned to normal activities without pain.
PRC was originally indicated for the remaining articular cartilage of the proximal capitate and lunate fossa. However, we performed PRC for wrists with severe damage and almost total loss of the cartilage, with interpositioning of the dorsal joint capsule, combined with the S-K procedure. Therefore, we consider that this procedure is an excellent rescue method for severely damaged wrist joints.
